Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparable efficacy and safety profile with those reported in clinical trial : a multi-center study

The induction therapy containing ixazomib, an oral proteasome inhibitor, has shown favorable efficacy and safety in clinical trials, but its experience in real-life remains limited. In routine practice, few patients received ixazomib-based induction therapy due to reasons including (1) patients' preference on oral regimens, (2) concerns on adverse events (AEs) of other intravenous/subcutaneous regimens, (3) requirements for less center visits, and (4) fears of COVID-19 and other infectious disease exposures. With the aim of assessing the real-life effectiveness and safety of ixazomib-based induction therapy, we performed this multi-center, observational study on 85 newly diagnosed multiple myeloma (NDMM) patients from 14 medical centers. Ixazomib-based regimens included ixazomib-lenalidomide-dexamethasone (IRd) in 44.7% of patients, ixazomib-dexamethasone (Id) in 29.4%, and Id plus another agent (doxorubicin, cyclophosphamide, thalidomide, or daratumumab) in 25.9%. Different ixazomib-based therapies were applied due to (1) financial burdens or limitations on local health insurance coverage, (2) concerns on treatment tolerance, and (3) drug accessibility issue. Ten patients received ixazomib maintenance. The median age was 67 years; 43.5% had ISS stage III disease; 48.2% had an Eastern Cooperative Oncology Group performance score ≥ 2; and 17.6% with high-risk cytogenetic abnormalities. Overall response rate for all 85 patients was 95.3%, including 65.9% very good partial response or better and 29.5% complete responses. The median time to response was 30 days. The response rate was similar across different ixazomib-based regimens. Median progression-free survival was not reached. Severe AEs (≥ grade 3) were reported in 29.4% of patients. No grade 3/4 peripheral neuropathy (PN) occurred. Patients received a median of 6 (range 1-20) cycles of ixazomib treatment; 56.6% remained on treatment at data cutoff; 15.3% discontinued treatment due to intolerable AEs. These results support that the ixazomib-based frontline therapy was highly effective with acceptable toxicity in routine practice and the ixazomib oral regimens could be good alternative options for NDMM patients.

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

Annals of hematology - Vol. 99, No. 11 (2020), p. 2589-2598

Language:

English

Contributors:

Li, Jing
Bao, Li
Xia, Zhongjun
Wang, Sili
Zhou, Xin
Ding, Kaiyang
Zhang, Wenhao
Yang, Wei
Li, Bingzong
Fu, Chengcheng
Chen, Bing
Hua, Luoming
Wang, Liang
Luo, Jun
Yang, Yang
Xu, Tianhong
Wang, Weida
Huang, Yun
Wu, Guolin
Liu, Peng

Links:

Volltext

Keywords:

4Z63YK6E0E
4Z8R6ORS6L
71050168A2
7S5I7G3JQL
80168379AG
8N3DW7272P
Adolescent
Adult
Aged
Antibodies, Monoclonal
Antineoplastic Combined Chemotherapy Protocols
Boron Compounds
Clinical Trial, Phase I
Clinical Trial, Phase II
Cyclophosphamide
Daratumumab
Dexamethasone
Doxorubicin
Drug Administration Schedule
F0P408N6V4
Female
Frontline
Glycine
Humans
Ixazomib
Journal Article
Lenalidomide
Male
Middle Aged
Multicenter Study
Multiple Myeloma
Myeloma
Neoplasm Staging
Observational Study
Peripheral Nervous System Diseases
Real-world
Remission Induction
Survival Analysis
TE7660XO1C
Thalidomide
Treatment Outcome

Notes:

Date Completed 13.10.2020

Date Revised 13.10.2020

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1007/s00277-020-04234-9

PMID:

32892275

PPN (Catalogue-ID):

NLM315597585