Real-world toxicity and effectiveness of ixazomib, lenalidomide, and dexamethasone in Korean patients with relapsed and/or refractory multiple myeloma

Int J Hematol. 2023 Feb;117(2):225-235. doi: 10.1007/s12185-022-03479-6. Epub 2022 Nov 11.

Abstract

Background/aim: Ixazomib, lenalidomide, and dexamethasone (IRd) have proven efficacy and an excellent safety profile in relapsed and/or refractory multiple myeloma (RRMM). However, there are limited reports on the real-world safety and effectiveness of IRd regimens in Asian patients with RRMM.

Patients and methods: This was a retrospective study of 60 patients with RRMM who were treated with IRd.

Results: The median patient age was 68 years. Forty percent of patients did not meet the eligibility criteria for the TOURMALINE-MM1 trial. Patients received a median of one prior line of therapy. Non-hematologic adverse events (AEs) were more common than hematologic AEs. The most common AE was skin rash, followed by gastrointestinal toxicities. Most grade 3 or higher AEs were observed in less than 5% of the patients, except for skin rashes and infections. IRd therapy did not aggravate peripheral neuropathy (PN) in 20 of the 24 patients with pre-existing peripheral neuropathy. The overall response rate was 85%. After a median follow-up of 26.3 months, the median progression-free survival was 25.9 months and overall survival was not reached.

Conclusion: Ixazomib and Rd combination therapy had a comparable toxicity profile and effectiveness in real-world RRMM patients.

Keywords: Asia; Ixazomib; Lenalidomide; Multiple myeloma; Real-world; Refractory; Relapsed.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Boron Compounds / adverse effects
  • Dexamethasone
  • Exanthema* / chemically induced
  • Humans
  • Lenalidomide
  • Multiple Myeloma*
  • Peripheral Nervous System Diseases* / chemically induced
  • Republic of Korea / epidemiology
  • Retrospective Studies

Substances

  • Lenalidomide
  • ixazomib
  • Dexamethasone
  • Boron Compounds