P-199: Real-world toxicity and efficacy of ixazomib, lenalidomide and dexamethasone in Asian RRMM patients supported by the patient assistance program

Abstract

Background The all-oral triplet therapy, ixazomib, lenalidomide, and dexamethasone (IRd), has shown superior progression-free survival (PFS) with excellent safety profile compared with Rd doublet therapy in relapsed and refractory multiple myeloma (RRMM) both in the prospective and retrospective studies. Still, there is limited report of IRd regimen in the real-world Asian RRMM population in terms of the safety and the efficacy Method Sixty RRMM patients treated with ixazomib, which was supported by the patient assistance program, in combination with Rd were retrospectively analyzed by the meticulous electronic medical record review. Results The median age was 68 years. Trial-ineligible patients due to ECOG performance status ≥ 3, platelet count <75,000/µL, creatinine clearance <30 mL/min, underlying heart or chronic active hepatitis B, unmeasurable disease, primary refractoriness to bortezomib, and remaining peripheral neuropathy after previous therapy were included in 35%. Patients had received a median 1 prior line of therapy. The overall response rate and the clinical benefit rate were 80% and 90%, respectively, and the PFS and overall survival was not reached after a median follow-up of 9.2 months. Thalidomide non-refractoriness and thalidomide response duration of ≥ 12 months in thalidomide responders significantly reduced the risk of progression. Non-hematologic adverse events (AEs) were more common than hematologic AEs, most commonly skin rash followed by gastrointestinal toxicities, and infections, and peripheral neuropathies. Grade 3 or higher AEs were observed but mostly in less than 5%. Conclusion Ixazomib and Rd combination therapy showed a comparable efficacy with a favorable toxicity profile especially in the early relapse of Asian RRMM patients. The all-oral triplet therapy, ixazomib, lenalidomide, and dexamethasone (IRd), has shown superior progression-free survival (PFS) with excellent safety profile compared with Rd doublet therapy in relapsed and refractory multiple myeloma (RRMM) both in the prospective and retrospective studies. Still, there is limited report of IRd regimen in the real-world Asian RRMM population in terms of the safety and the efficacy Sixty RRMM patients treated with ixazomib, which was supported by the patient assistance program, in combination with Rd were retrospectively analyzed by the meticulous electronic medical record review. The median age was 68 years. Trial-ineligible patients due to ECOG performance status ≥ 3, platelet count <75,000/µL, creatinine clearance <30 mL/min, underlying heart or chronic active hepatitis B, unmeasurable disease, primary refractoriness to bortezomib, and remaining peripheral neuropathy after previous therapy were included in 35%. Patients had received a median 1 prior line of therapy. The overall response rate and the clinical benefit rate were 80% and 90%, respectively, and the PFS and overall survival was not reached after a median follow-up of 9.2 months. Thalidomide non-refractoriness and thalidomide response duration of ≥ 12 months in thalidomide responders significantly reduced the risk of progression. Non-hematologic adverse events (AEs) were more common than hematologic AEs, most commonly skin rash followed by gastrointestinal toxicities, and infections, and peripheral neuropathies. Grade 3 or higher AEs were observed but mostly in less than 5%. Ixazomib and Rd combination therapy showed a comparable efficacy with a favorable toxicity profile especially in the early relapse of Asian RRMM patients.