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Open Access 01-11-2020 | Multiple Myeloma | Original Article

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

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

Published in: Annals of Hematology | Issue 11/2020

Abstract

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.

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Title: 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
Authors: Jing Li
Li Bao
Zhongjun Xia
Sili Wang
Xin Zhou
Kaiyang Ding
Wenhao Zhang
Wei Yang
Bingzong Li
Chengcheng Fu
Bing Chen
Luoming Hua
Liang Wang
Jun Luo
Yang Yang
Tianhong Xu
Weida Wang
Yun Huang
Guolin Wu
Peng Liu
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Multiple Myeloma
Daratumumab
Stem Cell Transplantation
Stem Cell Transplantion
Stem Cell Transplantation
Dexamethasone
Published in: Annals of Hematology / Issue 11/2020
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-020-04234-9

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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

Abstract

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