Efficacy of oral ixazomibe in combination with lenalidomide and dexamethasone in relapsed/refractory forms of multiple myeloma in real clinical practice

Ixazomib, the first oral proteasome inhibitor, is approved in combination with lenalidomidedexamethasone (Ixa-Rd) for the treatment of MM patients who previously received ≥ 1 line therapy. Approval was based on the results of an international multicenter, randomized, double-blind, placebo-controlled phase III study TOURMALINE-MM1. TOURMALINE-MM1 demonstrated a statistically significant improvement in progression-free survival when using ixazomib-Rd compared with placebo-Rd in patients with recurrent/ refractory multiple myeloma (RRMM). However, the results of clinical trials are not always translated into real results. In addition, they are often retrospective in nature. The REMIX study is one of the largest prospective, realworld analysis of the effectiveness of Ixa-Rd in the setting of RRMM. Among patients receiving Ixa-Rd as secondline treatment and as third-line treatment, median progression-free survival (mPFS) was similar for patients previously exposed to lenalidomide (19.5 months) than for those lenalidomide naive (not exposed, 22,6 months, p = 0,29). mPFS was 19,1 months in patients younger than 80 years and 17,4 months in those 80 years or older (p = 0,06). The results of the REMIX study are consistent with the results of TOURMALINE-MM1 and confirm the benefit of Ixa-Rd combination in real life. The Ixa-Rd regimen has proven to be a safe and effective treatment option for real patients with RRMM.