Ixazomib, lenalidomide, and dexamethasone is effective and well tolerated in multiply relapsed (≥2nd relapse) refractory myeloma: a multicenter real world UK experience

Abstract

There are limited real world data on ixazomib, lenalidomide, and dexamethasone (IRd) in multiply relapsed myeloma. We analyzed outcomes of 116 patients who received IRd predominantly at second and subsequent relapse including those refractory to proteasome inhibitors (PIs). With a median follow up 16.3 months, the overall response rate was 66.9%; median progression-free survival (PFS) was 17.7 months with median overall survival (OS) not reached (NR). PFS and OS were significantly shorter in advanced disease (PFS; 12.6 vs. 21.2 months (p = .01), OS; 15.9 months vs. NR (p = .01) for ISS3 vs. ISS 1&2, respectively). PFS and OS were significantly shorter in clinical high risk (CHR) compared to standard risk (SR) patients (PFS; 9.3 months vs. NR (p = .001), OS; 11.5 months vs. NR (p < .001), respectively). There was a trend toward shorter PFS in PI-refractory patients 13.7 vs. 19.6 months for non-PI refractory (p = .2). The triplet combination was generally well tolerated.

Keywords:

• Refractory
• ixazomib
• lenalidomide
• effectiveness
• safety
• real world

Disclosure statement

N.M. received honorarium, consultancy fees, speaker fees, conference attendance, grant from Takeda UK; speaker fees from Celgene and Novartis; conference fees from Janssen and Abbvie. B.K. received speaker honoraria and support to attend educational meeting from Takeda, Janssen Celgene. M.W.J. received honorarium, consultancy fees, speaker fees, conference attendance from Takeda, Celgene, and Janssen; consultancy fees from Amgen, Sanofi, and Abbvie. K.B. received speaker honoraria, attended advisory boards and support to attend educational meetings from Janssen, Celgene, Takeda, Novartis, and Amgen. G.D.V. received grant from Jazz Pharmaceuticals. M.D. received speaker fees from Amgen, attended advisory board from Takeda. F.C. received speaker fees form Takeda. C.B. received research support from Celgene and Janssen; honorarium from Janssen, Celgene, Takeda, Amgen, and attended scientific advisory board from Sanofi, Bristol Myers Squibb. K.R. received research support and attended advisory board from Celgene, Takeda, Janssen, Amgen, received speaker’s fees from Takeda and attended advisory board from Abbvie, Sanofi, and Oncopeptides. The remaining authors have stated that they have no conflicts of interest.

Additional information

Funding

The first author thanks Oxford NIHR BRC Research Education and Training Group for providing research fellowship funding.