Evaluating the long-term outcomes of ixazomib in combination with Rd for patients with relapsed or refractory multiple myeloma

This trial looked at the long-term effectiveness and safety of ixazomib (Ixa; Ninlaro) in combination with lenalidomide (R; Revlimid), and dexamethasone (d; Decadron) for the treatment of relapsed/refractory (RR) multiple myeloma (MM). The authors found that there was an improved survival with Ixa-Rd combination particularly in patients with unfavorable risk factors.

MM is a form of cancer that comes from a type of white blood cells called a plasma cell. Despite current treatment options, MM remains difficult to treat, particularly in patients with RRMM.

The combination of Ixa with Rd has shown to improve survival without disease worsening compared to Rd alone in the short-term. However, the long-term of Ixa-Rd in patients with RRMM are still unknown.

There were 722 patients with RRMM included in this trial. Patients were randomly assigned to receive either Ixa-Rd or Rd and a placebo. The average length of follow-up was 85 months. 

Overall, the average survival was 53.6 months in the Ixa-Rd group compared to 51.6 months in the Rd-placebo group. However, Ixa-Rd was associated with a better survival in patients with higher-risk genetic mutations such as del(17p). It also had better survival in patients older than 65-75 years, in those who did not respond to their previous therapies(s), or those who did not respond to thalidomide (Thalomid). 

There were no new concerning side effects to Ixa-Rd therapy.

The authors found that in the long-term, the addition of Ixa to Rd benefitted particularly high-risk patients with RRMM.  

This trial was supported by Takeda Pharmaceutical Company Limited, the manufacturers of ixazomib.