Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparab
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ORIGINAL ARTICLE
Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparable efficacy and safety profile with those reported in clinical trial: a multi-center study Jing Li 1 & Li Bao 2 & Zhongjun Xia 3 & Sili Wang 4 & Xin Zhou 5 & Kaiyang Ding 6 & Wenhao Zhang 7 & Wei Yang 8 & Bingzong Li 9 & Chengcheng Fu 10 & Bing Chen 11 & Luoming Hua 12 & Liang Wang 13 & Jun Luo 14 & Yang Yang 1 & Tianhong Xu 1 & Weida Wang 3 & Yun Huang 4 & Guolin Wu 6 & Peng Liu 1 Received: 9 June 2020 / Accepted: 24 August 2020 # The Author(s) 2020
Abstract The induction therapy containing ixazomib, an oral proteasome inhibitor, has shown favorable efficacy and safety in clinical trials, but its experience in real-life remains limited. In routine practice, few patients received ixazomib-based induction therapy due to reasons including (1) patients’ preference on oral regimens, (2) concerns on adverse events (AEs) of other intravenous/subcutaneous regimens, (3) requirements for less center visits, and (4) fears of COVID-19 and other infectious disease exposures. With the aim of assessing the real-life effectiveness and safety of ixazomib-based induction therapy, we performed this multi-center, observational study on 85 newly diagnosed multiple myeloma (NDMM) patients from 14 medical centers. Ixazomib-based regimens included ixazomib-lenalidomide-dexamethasone (IRd) in 44.7% of patients, ixazomib-dexamethasone (Id) in 29.4%, and Id plus another agent (doxorubicin, cyclophosphamide, thalidomide, or daratumumab) in 25.9%. Different ixazomib-based therapies were applied due to (1) financial burdens or limitations on local health insurance coverage, (2) concerns on treatment tolerance, and (3) drug accessibility issue. Ten patients received ixazomib maintenance. The median age was 67 years; 43.5% had ISS stage III disease; 48.2% had an Eastern Cooperative Oncology Group performance score ≥ 2; and 17.6% with high-risk cytogenetic abnormalities. Overall response rate for all 85 patients was 95.3%, including 65.9% very good partial response or better and 29.5% complete responses. The median time to response was 30 days. The response rate was similar across different ixazomib-based regimens. Median progression-free survival was not reached. Severe AEs (≥ grade 3) were reported in 29.4% of patients. No grade 3/4 peripheral neuropathy (PN) occurred. Patients received a median of 6 (range 1–20) cycles of ixazomib treatment; 56.6% remained on treatment at data cutoff; 15.3% discontinued treatment due to intolerable AEs. These results support that the ixazomib-based
Jing Li, Li Bao and Zhongjun Xia contributed equally to this work. * Peng Liu [email protected] 1
Department of Hematology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People’s Republic of China
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Shengjing Hospital of China Medical University, Shengjing, China
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The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Department of Hematology, The First Affilia
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