Cancer Treatment Today

My review shows that patients with newly diagnosed multiple myeloma may benefit from a combination of Ninlaro (ixazomib) plus Revlimid (lenalidomide) and dexamethasone, Ninlaro maintenance therapy after RVD, according to long-term follow-up data of two Phase 1/2 trials presented at the 2017 European Hematology Association annual meeting, held June 22-25 in Madrid, Spain.

In the first one, patients who went on to receive single-agent maintenance Ninlaro therapy after RVD, there was an increased depth of response, with 32% of patients showing improved response during maintenance therapy. There was less toxicity reported in the maintenance period compared to the induction period, but still some. The second phase I/II study showed that patients who went on to receive single-agent maintenance Ninlaro therapy, 22% improved their response during treatment.

Both studies were early phase, had significant toxicity and were in first line.

In 2016, the following was added to the NCCN guideline:” Ixazomib and single agent; Ixazomib in combination with dexamethasone; and ixazomib in combination with lenalidomide/dexamethasone, with a new footnote, “Indicated for the treatment of patients who have received at least one prior therapy.” 

1. 1.    Deep and Durable Responses with Weekly Ixazomib, Lenalidomide and Dexamethasone in Patients with Newly Diagnosed Multiple Myeloma: Long-Term Follow-up of Patients who did not Undergo SCT (Abstract S408, oral presentation at 11:45 a.m. CEST on June 24, 2017 at IFEMA Madrid, Hall A) https://www.businesswire.com/news/home/20170623005011/en/Takeda-Presents-Data-Phase-12-Studies-NINLARO%E2%84%A2
2. 2.    NCCN, Multiple Myeloma 2016 and 2018
3. 3.    Ninlaro, Prescribing Information 2018