Is Ixazomib, thalidomide and dexamethasone effective in treating relapsed and/or refractory multiple myeloma?

This article looked at the effectiveness and safety of continuous ixazomib (Ninlaro), thalidomide (Thalomid), and dexamethasone (Decadron) (ITd) in the treatment of relapsed and/or refractory (RR) multiple myeloma (MM). The authors found that this regimen was well tolerated and showed promising effectiveness in the treatment of RRMM.

MM is a form of cancer that originates from plasma cells (a form of white blood cell). This usually results in other normal cells of the bone marrow not working properly. MM is usually diagnosed in older patients. Despite new therapies being developed MM remains incurable.

Proteasome inhibitors (PIs) such as bortezomib (Velcade) have become an option in treating MM. PIs work by blocking the misfolding of protein. These proteins can contribute towards cancer cells becoming resistant to treatment. Ixazomib is a new PI that is currently under investigation for the treatment of RRMM. Thalidomide and dexamethasone are drugs used in the treatment of MM that regulate the immune response. The combination of ixazomib, thalidomide, and dexamethasone (ITd) is less expensive than other existing novel treatments and until now its effectiveness and safety are not clear in patients with RRMM. 

There were 39 patients with RRMM involved in this study. Patients had previously received 1-3 previous lines of therapy. All patients were treated with an average of 11 cycles of ITd. The average follow-up period was 31.3 months.

56.4% of patients responded to treatment. There was a clinical benefit recorded in 71.8% of patients. Clinical benefit is when the tumor disappears, shrinks, or does not progress during treatment. Response lasted for an average of 18.4 months. Side effects were reported in 87.2% of patients. 

The authors concluded that ITd was effective and was tolerated in patients with RRMM. 

This study was funded by Takeda Pharmaceutical International, Inc, the manufacturers of ixazomib. This study had a small number of participants and did not have a comparison group.