Ixazomib, Lenalidomide, and Dexamethasone in Myeloma: Routine Clinical Practice Versus Clinical Trials
Posted: Thursday, May 27, 2021
Treatment of relapsed or refractory multiple myeloma using the proteasome inhibitor ixazomib, plus lenalidomide and dexamethasone appears to be both effective and safe in routine clinical practice, supporting results seen in prior phase III clinical trials. These data were published in Future Medicine by Roman Hájek, MD, PhD, of the University of Ostrava, Czech Republic, and his colleagues.
Researchers performed a pooled analysis of data for patients with relapsed and refractory multiple myeloma who had received the triplet therapy of ixazomib, lenalidomide, and dexamethasone as a part of the phase III INSIGHT MM and Czech RMG trials. A total of 263 patients from 13 countries were included in the analysis; 132 from the INSIGHT MM trial and 131 from the Czech RMG trial.
After a median follow-up of 14.8 months, the overall response rate was 73%, and 37% of patients achieved a very good partial response. The median time to best response was 3.4 months among INSIGHT MM patients, whereas those enrolled in the Czech RMG trial had a median time to partial response or better of 1.2 months. The median duration of therapy was 11.8 months; this was notably longer among patients who received the therapy in the second or third line (12.8, 13.0 months, respectively) compared with patients receiving the regimen in fourth or higher line (8.5, 5.2 months). The overall mean progression-free survival was 21.2 months, and the median overall survival was not yet reached.
By the time of data cutoff, 159 patients (61%) had discontinued the therapy. The most common reason for treatment discontinuation was relapse or disease progression (43%); 14% of patients completed treatment, 11% died, and 7% had an adverse event leading to the cessation of treatment. Discontinuation of ixazomib and lenalidomide was necessary in 32% and 30% of patients, respectively, due to adverse events. Common adverse events leading to ixazomib discontinuation included infection (19%), neutropenia, or thrombocytopenia (6% each). Adverse events necessitating lenalidomide discontinuation included infection (20%), neutropenia (6%), and thrombocytopenia (5%).
Disclosure: For a full list of authors’ disclosures, visit futuremedicine.com.