Outcomes of ixazomib/lenalidomide/dexamethasone for multiple myeloma: A multicenter retrospective analysis

Eur J Haematol. 2021 Apr;106(4):555-562. doi: 10.1111/ejh.13586. Epub 2021 Jan 31.

Abstract

Objectives: This study aimed to investigate real-world data of ixazomib plus lenalidomide and dexamethasone (IRd) therapy for patients with relapsed and refractory multiple myeloma (RRMM).

Methods: We retrospectively analyzed 122 patients treated with IRd at 16 centers from May 2017 to January 2019 by using the Kansai Myeloma Forum database.

Result: At the start of IRd, the median age was 72 years, 66.7% of patients had IgG type, and the median number of prior therapies was 4, comprising bortezomib (85.4%) and lenalidomide (89.3%)-based regimens. Disease progression and adverse events accounted for treatment discontinuation in 46 and 32 patients, respectively. The median overall survival (OS) was not reached, and the median progression-free survival (PFS) was 11.9 months. Sensitivity to bortezomib did not affect the PFS, whereas lenalidomide-refractory patients had significantly lower PFS than lenalidomide-sensitive patients, who were comparable to TOURMALINE-MM1 study. The patients with IgG type had significantly better PFS and OS than those with non-IgG type.

Conclusion: This study presents the largest real-world data of patients treated with IRd in Asia. However, in real clinical practice, the patient background is different from the TOURMALINE-MM1 study, and IRd showed poor efficacy, especially in the non-IgG type and lenalidomide-refractory patients with RRMM.

Keywords: ixazomib; lenalidomide; multiple myeloma; real-world.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor
  • Boron Compounds / administration & dosage
  • Dexamethasone / administration & dosage
  • Female
  • Glycine / administration & dosage
  • Glycine / analogs & derivatives
  • Humans
  • Kaplan-Meier Estimate
  • Lenalidomide / administration & dosage
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / etiology
  • Multiple Myeloma / mortality
  • Neoplasm Staging
  • Prognosis
  • Retreatment
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • Boron Compounds
  • ixazomib
  • Dexamethasone
  • Lenalidomide
  • Glycine