Most Read Articles
4 days ago
Combining the DASH (Dietary Approaches to Stop Hypertension) diet with low sodium intake reduces systolic blood pressure (SBP) in individuals with pre- and stage 1 hypertension, with progressively higher reductions at greater levels of baseline SBP, a recent study has shown.
Tristan Manalac, 2 days ago
Major depressive disorder (MDD) appears to be more prevalent in females than in males, particularly in those who are divorced or widowed, a recent study from Singapore has found.
3 days ago
Tadalafil may not be effective for reducing the decline in ambulatory ability in boys with Duchenne muscular dystrophy (DMD), as shown in a recent study.
6 days ago
Hydrochlorothiazide (HCTZ) appears to significantly increase the risks of nonmelanoma skin cancer (NMSC), particularly squamous cell carcinoma (SCC), a recent study has shown.

Ixazomib plus lenalidomide-dexamethasone improves PFS, OS in multiple myeloma

Audrey Abella
07 Sep 2017

Combining ixazomib with lenalidomide and dexamethasone improved progression-free survival (PFS) and overall survival (OS) over lenalidomide plus dexamethasone in patients with relapsed/refractory multiple myeloma (RRMM) previously treated with one to three treatments, according to the China Continuation study.

A total of 115 Chinese patients were randomized to receive ixazomib 4.0 mg (n=57) or placebo (n=58) on days 1, 8, and 15, plus lenalidomide 25 mg (days 121) and dexamethasone 40 mg (days 1, 8, 15, and 22) in 28‑day cycles. [J Hematol Oncol 2017;doi:10.1186/s13045-017-0501-4]

The ixazomib-lenalidomide-dexamethasone combination was superior to the lenalidomide-dexamethasone combination in terms of PFS (median 6.7 vs 4.0 months; hazard ratio [HR], 0.598, 95 percent confidence interval [CI], 0.3670.972; p=0.035) after a median follow-up of 7.4 and 6.9 months for the respective groups.

There was also a significant OS benefit favouring the ixazomib-lenalidomide-dexamethasone combination over lenalidomide-dexamethasone (median 25.8 vs 15.8 months; HR, 0.419, 95 percent CI, 0.2420.726; p=0.001) after a median follow-up of 20.2 and 19.1 months, respectively.

“[The] OS findings are indicative of a treatment effect rather than an effect driven by imbalances between arms in patient subgroups, subsequent therapies, or non-MM-related deaths,” said the researchers.

Grade 3 adverse events (AEs) were reported by 67 and 74 percent of participants in the ixazomib-lenalidomide-dexamethasone and lenalidomide-dexamethasone arms, respectively.

This study was a separate regional extension of the global TOURMALINE-MM1* study. [N Engl J Med 2016;374:1621-1634] However, despite identical eligibility criteria and dosing regimens, median PFS in the current study was lower compared with the global trial.

“[S]ubsequent therapy in China is different from Western populations … [The] differences are likely attributable to the fact that Chinese MM patients present with more advanced stage disease … than patients in other regions,” said the researchers.

Overall, the 4.0 mg/week ixazomib dose combined with lenalidomide-dexamethasone demonstrated a favourable benefit-risk profile in Chinese patients with RRMM, noted the researchers. “[The present] findings provide supportive evidence for the activity, tolerability, and safety of the all-oral triplet regimen of [ixazomib-lenalidomide-dexamethasone] … as a treatment option for patients with RRMM around the world,” they said.

Despite the introduction of advanced treatment options over the last two decades, MM remains incurable. [Leukemia 2014;28:1122-1128] Furthermore, there has been an increasing incidence of MM in Asia, hence the need for further evaluation of new treatment alternatives. [Am J Hematol 2014;89:751-756; Lancet 2016;387:251-272; N Engl J Med 2014;371:906-917; J Clin Oncol 2015;33:3459-3466]

“[S]pecific investigation of … therapies in Asian populations is important in the context of differences in the clinical profile of MM and treatment patterns compared with [therapies] in North America and Europe,” said the researchers.

 

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
4 days ago
Combining the DASH (Dietary Approaches to Stop Hypertension) diet with low sodium intake reduces systolic blood pressure (SBP) in individuals with pre- and stage 1 hypertension, with progressively higher reductions at greater levels of baseline SBP, a recent study has shown.
Tristan Manalac, 2 days ago
Major depressive disorder (MDD) appears to be more prevalent in females than in males, particularly in those who are divorced or widowed, a recent study from Singapore has found.
3 days ago
Tadalafil may not be effective for reducing the decline in ambulatory ability in boys with Duchenne muscular dystrophy (DMD), as shown in a recent study.
6 days ago
Hydrochlorothiazide (HCTZ) appears to significantly increase the risks of nonmelanoma skin cancer (NMSC), particularly squamous cell carcinoma (SCC), a recent study has shown.