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. 2024 Aug;113(2):190-200.
doi: 10.1111/ejh.14214. Epub 2024 Apr 23.

Impact of prior lenalidomide or proteasome inhibitor exposure on the effectiveness of ixazomib-lenalidomide-dexamethasone for relapsed/refractory multiple myeloma: A pooled analysis from the INSURE study

Hans C Lee  1 , Karthik Ramasamy  2 , Margaret Macro  3 , Faith E Davies  4 , Rafat Abonour  5 , Frits van Rhee  6 , Vania T M Hungria  7 , Noemi Puig  8 , Kaili Ren  9 , Jiri Silar  10 , Victoria Enwemadu  11 , Dasha Cherepanov  9 , Xavier Leleu  12
Affiliations

Impact of prior lenalidomide or proteasome inhibitor exposure on the effectiveness of ixazomib-lenalidomide-dexamethasone for relapsed/refractory multiple myeloma: A pooled analysis from the INSURE study

Hans C Lee et al. Eur J Haematol. 2024 Aug.

Abstract

Objectives: To characterize the impact of prior exposure and refractoriness to lenalidomide or proteasome inhibitors (PIs) on the effectiveness and safety of ixazomib-lenalidomide-dexamethasone (IRd) in relapsed/refractory multiple myeloma (RRMM).

Methods: INSURE is a pooled analysis of adult RRMM patients who had received IRd in ≥2 line of therapy from three studies: INSIGHT MM, UVEA-IXA, and REMIX.

Results: Overall, 391/100/68 were lenalidomide-naïve/-exposed/-refractory and 37/411/110 were PI-naïve/-exposed/-refractory. Median duration of therapy (DOT) was 15.3/15.6/4.7 months and median progression-free survival (PFS) was 21.6/25.8/5.6 months in lenalidomide-naïve/exposed/refractory patients. Median DOT and PFS in PI-naïve/exposed/refractory patients were 20.4/15.2/6.9 months and not reached/19.8/11.4 months, respectively. The proportion of lenalidomide-naïve/exposed/refractory patients in INSIGHT and UVEA-IXA who discontinued a study drug due to adverse events (AEs) was ixazomib, 31.6/28.2/28.0% and 18.6/6.7/10.5%; lenalidomide, 21.9/28.2/16.0% and 16.1/6.7/10.5%; dexamethasone, 18.4/20.5/16.0% and 10.6/0/10.5%, respectively. The proportion of PI-naïve/exposed/refractory patients in INSIGHT and UVEA-IXA who discontinued a study drug due to AEs was: ixazomib, 44.4/28.8/27.8% and 22.2/16.7/15.7%; lenalidomide, 33.3/22.0/19.4% and 16.7/15.9/11.8%; dexamethasone, 33.3/17.4/16.7% and 16.7/9.5/7.8%, respectively. REMIX AE discontinuation rates were unavailable.

Conclusion: IRd appeared to be effective in RRMM patients in routine clinical practice regardless of prior lenalidomide or PI exposure, with better outcomes seen in lenalidomide- and/or PI-nonrefractory versus refractory patients.

Keywords: effectiveness; ixazomib; lenalidomide; multiple myeloma; prior treatment exposure; proteasome inhibitor; relapsed/refractory.

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References

REFERENCES

    1. NINLARO. US Prescribing Information. NINLARO; 2022 Accessed January 2023. https://www.ninlaro.com/prescribing-information.pdf
    1. European Medicines Agency. Summary of Product Characteristics. European Medicines Agency; 2023 Accessed February 2024. https://www.ema.europa.eu/en/documents/product‐information/ninlaro‐epar‐...
    1. Moreau P, Masszi T, Grzasko N, et al. Oral ixazomib, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016;374(17):1621‐1634.
    1. Puig N, Abonour R, Davies FE, et al. Real‐world duration of treatment (DOT) with lenalidomide‐dexamethasone (rd)‐based regimens in patients (pts) with relapsed/refractory multiple myeloma (RRMM): outcomes from the global INSIGHT MM study. HemaSphere. 2021;5(Suppl 2):463.
    1. Ludwig H, Terpos E, Mateos M‐V, et al. Effectiveness and safety of ixazomib‐based therapy in relapsed/refractory multiple myeloma (MM) outside of a clinical trial: final analysis of the ‘use via early access to ixazomib’ (UVEA IXA) study. HemaSphere. 2021;5(Suppl 2):468.

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