Contributions
Abstract: PB1975
Type: Publication Only
Background
Ixazomib (Ixa) is a novel oral proteasome inhibitor (PI) approved in combination with lenalidomide and dexamethasone (IRD) for the treatment of relapsed/refractory multiple myeloma (MM). This was based on the TOURMALINE-MM1 trial which demonstrated a progression free survival benefit over RD. However real world use often differs to clinical trials due to heterogeneous patient selection, more flexibility with dosing intensity and country specific prescribing practices/funding restrictions.
Aims
To characterise real word use of IRD by demographics, response rate (RR) and progression free survival.
Methods
This was a retrospective review of patients sequentially treated with IRD at a large UK Haematology Centre. Patients received Ixa 4mg D1, 8, 15 with lenalidomide (dose as per label) days 1-21 and dexamethasone 40mg weekly or as tolerated every 28 days until disease progression or intolerance. In some cases, Ixa was added later to RD. RR and PFS were assessed according to IMW criteria and haematological toxicities graded by CTCAE 4.0 criteria.
Results
Conclusion
This real world dataset highlights differences in patients treated in routine practice to trials. No patients were treated at first relapse due to funding restrictions, whereas most in the trial were. Patients had up to 5 prior lines, all had prior PI exposure and a higher proportion were PI refractory (33% vs 2%) which correlated with a worse outcome. Nevertheless the overall efficacy of our study (ORR 70.8%; median PFS 19.23 months) was comparable to the TOURMALINE-MM1 trial which had an ORR of 78.3% and median PFS of 20.6 months in the Ixa group.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Refractory, Proteasome inhibitor, Myeloma, Clinical data
Abstract: PB1975
Type: Publication Only
Background
Ixazomib (Ixa) is a novel oral proteasome inhibitor (PI) approved in combination with lenalidomide and dexamethasone (IRD) for the treatment of relapsed/refractory multiple myeloma (MM). This was based on the TOURMALINE-MM1 trial which demonstrated a progression free survival benefit over RD. However real world use often differs to clinical trials due to heterogeneous patient selection, more flexibility with dosing intensity and country specific prescribing practices/funding restrictions.
Aims
To characterise real word use of IRD by demographics, response rate (RR) and progression free survival.
Methods
This was a retrospective review of patients sequentially treated with IRD at a large UK Haematology Centre. Patients received Ixa 4mg D1, 8, 15 with lenalidomide (dose as per label) days 1-21 and dexamethasone 40mg weekly or as tolerated every 28 days until disease progression or intolerance. In some cases, Ixa was added later to RD. RR and PFS were assessed according to IMW criteria and haematological toxicities graded by CTCAE 4.0 criteria.
Results
Conclusion
This real world dataset highlights differences in patients treated in routine practice to trials. No patients were treated at first relapse due to funding restrictions, whereas most in the trial were. Patients had up to 5 prior lines, all had prior PI exposure and a higher proportion were PI refractory (33% vs 2%) which correlated with a worse outcome. Nevertheless the overall efficacy of our study (ORR 70.8%; median PFS 19.23 months) was comparable to the TOURMALINE-MM1 trial which had an ORR of 78.3% and median PFS of 20.6 months in the Ixa group.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Refractory, Proteasome inhibitor, Myeloma, Clinical data