Real-world effectiveness and safety of ixazomib-lenalidomide-dexamethasone in relapsed/refractory multiple myeloma

• DOI: 10.1007/s00277-020-03981-z
• Publication Date: 2020-04-01T02:02:43Z
• Authors: Evangelos Terpos; Karthik Ramasamy; Nadjoua Maouche; Jiri Minarik; Ioannis Ntanasis-...; Eirini Katodritou; Matthew W. Jenner; Hana Plonkova; Maria Gavriatopoulou; Grant D. Vallance; Tomas Pika; Maria Kotsopoulou; Jaimal Kothari; Tomas Jelinek; Efstathios Kastritis; Robin Aitchison; Meletios A. Dimop...; Athanasios Zomas; Roman Hajek
• Keywords: Adult; Aged, 80 and over; Boron Compounds; Male; Glycine; Middle Aged; Dexamethasone; Disease-Free Survival; 3. Good health; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Recurrence; Antineoplastic Combined Chemotherapy Protocols; Humans; Female; Multiple Myeloma; Lenalidomide; Aged

Real-world data on regimens for relapsed/refractory multiple myeloma (RRMM) represent an important component of therapeutic decision-making. This multi-centric, retrospective, observational study conducted by the treating physicians evaluated the effectiveness and safety of ixazomib-lenalidomide-dexamethasone (IRd) in 155 patients who received ixazomib via early access programs in Greece, the UK, and the Czech Republic. Median age was 68 years; 17% had an Eastern Cooperative Oncology Group performance status ≥ 2; median number of prior therapies was 1 (range 1-7); 91%, 47%, and 17% had received prior bortezomib, thalidomide, and lenalidomide, respectively. Median duration of exposure to ixazomib was 9.6 months. Overall response rate was 74%, including 35% very good partial response or better (16% complete response). Median progression-free survival (PFS) was 27.6 months (27.6 and 19.9 months in patients with 1 or > 1 prior lines, respectively). IRd treatment for ≥ 6 months was associated with longer PFS (hazard ratio 0.06). Fourteen patients (9%) discontinued IRd due to adverse events/toxicity in the absence of disease progression. Peripheral neuropathy was reported in 35% of patients (3% grades 3-4). These findings support the results of the phase III TOURMALINE-MM1 trial in a broader real-world RRMM population.