Keywords
Relapsed/refractory multiple myeloma
Clinical efficacy
Adverse event
Submitted : 2022-06-27
Accepted : 2022-07-12
Published : 2022-07-27
Abstract
Objective: To investigate the clinical efficacy and safety of ixazomib in the treatment of relapsed/refractory multiple myeloma (RRMM). Methods: The clinical data of 20 patients with RRMM admitted to the hospital from January 2020 to January 2022 were analyzed retrospectively. All patients were treated with ixazomib-based chemotherapy regimen (IRD regimen 13 cases; ID regimen 7 cases). The objective response rate (ORR) and adverse events (AEs) were observed. Results: All 20 patients received two to seven courses of treatment, in which the median was three courses. One patient had CR, four patients had VGPR, seven patients had PR, two patients had SD, and six patients had PD. The ORR was 60.00% (12/20), and 25.00% (5/20) of them had VGPR or more. The ORR of patients with previous treatment lines ? 3, ISS stage III, and high-risk cytogenetic was lower than that of patients with previous treatment lines < 3, ISS stage I/II, and low-risk cytogenetics. The main AEs include anemia, thrombocytopenia, neutropenia, nausea and vomiting, diarrhea, constipation, and respiratory tract infection, most of which are grade I/II. Conclusion: Ixazomib is effective in the treatment of RRMM in some patients, and the AEs are controllable. Patients who had received less than 3 lines of treatment in the past, with ISS stage I to II and low-risk cytogenetics had better treatment effect.
References
Brigle K, Rogers B, 2017, Pathobiology and Diagnosis of Multiple Myeloma. Semin Oncol Nurs, 33(3): 225–236.
Kazandjian D, 2016, Multiple Myeloma Epidemiology and Survival: A Unique Malignancy. Semin Oncol, 43(6): 676–681.
Moreau P, Masszi T, Grzasko N, et al., 2016, Oral Ixazomib, Lenalidomide, and Dexamethasone for Multiple Myeloma. N Engl J Med, 374(17): 1621–1634.
Chinese Hematology Association, Chinese Society of Hematology, Chinese Myeloma Committee-Chinese Hematology Association, 2020, The Guidelines for the Diagnosis and Management of Multiple Myeloma in China (2020 Revision). Chin J Intern Med, 59(5): 341–346.
Kumar S, Paiva B, Anderson KC, et al., 2016, International Myeloma Working Group Consensus Criteria for Response and Minimal Residual Disease Assessment in Multiple Myeloma. Lancet Oncol, 17(8): e328–e346.
Freites-Martinez A, Santana N, Arias-Santiago S, et al., 2021, Using the Common Terminology Criteria for Adverse Events (CTCAE – Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies. Actas Dermosifiliogr (Engl Ed), 112(1): 90–92.
Dimopoulos MA, Lonial S, White D, et al., 2020, Elotuzumab, Lenalidomide, and Dexamethasone in RRMM: Final Overall Survival Results from the Phase 3 Randomized ELOQUENT-2 Study. Blood Cancer J, 10(9): 91.
Tabayashi T, 2019, Management of Multiple Myeloma in the Relapsed/Refractory Patient. Rinsho Ketsueki, 60(9): 1257–1264.
Gentile M, Offidani M, Vigna E, et al., 2015, Ixazomib for the Treatment of Multiple Myeloma. Expert Opin Investig Drugs, 24(9): 1287–1298.
Yang Y, Li Y, Gu H, et al., 2020, Emerging Agents and Regimens for Multiple Myeloma. J Hematol Oncol, 13(1): 150.
Hinsley S, Walker K, Sherratt D, et al., 2020, Myeloma UK Clinical Trials Network. The MUK Eight Protocol: A Randomised Phase II Trial of Cyclophosphamide and Dexamethasone in Combination with Ixazomib, in Relapsed or Refractory Multiple Myeloma (RRMM) Patients Who Have Relapsed After Treatment with Thalidomide, Lenalidomide and a Proteasome Inhibitor. Trials, 21(1): 826.
Xie J, Wan N, Liang Z, et al., 2019, Ixazomib – The First Oral Proteasome Inhibitor. Leuk Lymphoma, 60(3): 610–618.
He Y, Zhang K, Zou L, et al., 2020, Clinical Study on Ixazomib in the Treatment of Multiple Myeloma. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 45(3): 322–327.
Cohen YC, Magen H, Lavi N, et al., 2020, Ixazomib-Based Regimens for Relapsed/Refractory Multiple Myeloma: Are Real-World Data Compatible with Clinical Trial Outcomes? A Multi-Site Israeli Registry Study. Ann Hematol, 99(6): 1273–1281.
Terpos E, Ramasamy K, Maouche N, et al., 2020, Real-World Effectiveness and Safety of Ixazomib-Lenalidomide-Dexamethasone in Relapsed/Refractory Multiple Myeloma. Ann Hematol, 99(5): 1049–1061.
Avet-Loiseau H, Bahlis NJ, Chng WJ, et al., 2017, Ixazomib Significantly Prolongs Progression-Free Survival in High-Risk Relapsed/Refractory Myeloma Patients. Blood, 130(24): 2610–2618.
Ludwig H, Poenisch W, Knop S, et al., 2019, Ixazomib-Thalidomide-Dexamethasone for Induction Therapy Followed by Ixazomib Maintenance Treatment in Patients with Relapsed/Refractory Multiple Myeloma. Br J Cancer, 121(9): 751–757.
Takakuwa T, Yamamura R, Ohta K, et al., 2021, Outcomes of Ixazomib/Lenalidomide/Dexamethasone for Multiple Myeloma: A Multicenter Retrospective Analysis. Eur J Haematol, 106(4): 555–562.
Siegel DS, Schiller GJ, Song KW, et al., 2020, Pomalidomide Plus Low-Dose Dexamethasone in Relapsed Refractory Multiple Myeloma After Lenalidomide Treatment Failure. Br J Haematol, 188(4): 501–510.
Davies F, Rifkin R, Costello C, et al., 2021, Real-World Comparative Effectiveness of Triplets Containing Bortezomib (B), Carfilzomib (C), Daratumumab (D), or Ixazomib (I) in Relapsed/Refractory Multiple Myeloma (RRMM) in the US. Ann Hematol, 100(9): 2325–2337.