Ixazomib Combos Both OK for Frontline Use in Elderly Patients with Multiple Myeloma

A prospective multicenter trial found that the use of either ixazomib plus liposome doxorubicin (IAd) or ixazomib plus lenalidomide (IRd) was safe and effective for use as frontline treatment in fragile elderly patients with multiple myeloma (MM).

Results were presented at the 2021 International Myeloma Workshop.

The study included 95 patients from 14 hospitals in China. The median age of patients was 71 years. Patients were treated with four-week cycles of IAd or IRd. and patients with partial remission after six to eight cycles could go on lenalidomide maintenance.

At a median follow-up of 10 months, the overall response rate was 80.9%. Response for IAd was 80.9% and for IRd was 81.0%. Median progression-free survival was 16 months for IAd, versus not reached for IRd. Overall survival was not reached for both groups. The 12-month overall survival rate was 81.0%.

Among those patients stratified as having high-risk cytogenetics, those with two or more risk factors had a median overall survival of 14 months. The overall survival of patients with one or no high-risk cytogenetics was not yet reached at time of analysis (P = 0.05).

More serious neurotoxicity occurred in patients treated with IRd: five patients had delirium, mental disorder or cerebral infarction. In all 16 patients died, including seven early deaths due to progression, four early deaths (<60 days), four treatment abandonment, and one unexplained sudden death.

These data are from Abstract P-160 “Efficacy and safety of induction therapy with IAd versus IRd regimen in fragile elderly patients with newly diagnosed multiple myeloma—Results of a prospective multicenter clinical trial,” presented at IMW 2021, September 8-11, 2021.