1. Twice-weekly induction with ixazomib-lenalidomide-dexamethasone (IRd) combination followed by extended IRd consolidation and lenalidomide maintenance in transplant-eligible patients with newly diagnosed multiple myeloma: Results of the phase 2 study IFM2014-03.
- Author
-
Perrot A, Roussel M, Lauwers-Cances V, Hulin C, Leleu X, Touzeau C, Facon T, Mariette C, Schiano JM, Gay J, Montes L, Ranta D, Huguet A, Wuillème S, Dejoie T, Devlamynck L, Corre J, Avet-Loiseau H, Moreau P, and Attal M
- Subjects
- Humans, Middle Aged, Female, Male, Aged, Adult, Consolidation Chemotherapy methods, Maintenance Chemotherapy, Hematopoietic Stem Cell Transplantation methods, Lenalidomide administration & dosage, Lenalidomide adverse effects, Lenalidomide therapeutic use, Multiple Myeloma drug therapy, Multiple Myeloma mortality, Dexamethasone administration & dosage, Dexamethasone therapeutic use, Dexamethasone adverse effects, Glycine analogs & derivatives, Glycine administration & dosage, Glycine therapeutic use, Glycine adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Boron Compounds administration & dosage, Boron Compounds therapeutic use, Boron Compounds adverse effects
- Abstract
Therapeutic strategies for patients with newly diagnosed multiple myeloma (NDMM) have considerably improved during the last 10 years. The IFM2014-03 trial proposed an all-oral triplet induction/consolidation regimen in transplant-eligible NDMM patients, followed by lenalidomide maintenance. Induction consisted of three 21-day cycles of ixazomib, lenalidomide and dexamethasone (IRd), before high-dose Melphalan with transplant followed by eight 28-day cycles of IRd consolidation before 13 cycles of lenalidomide maintenance. Forty-six patients were enrolled and received at least one dose of therapy, and 39 entered the maintenance phase. The primary end-point was stringent complete response after consolidation, and was achieved in nine patients (20.9%, 90% CI 11.4-33.7; p = 0.998). Ten patients (24.4%) had an undetectable minimal residual disease. The overall response rate was 95.7%. The 3-year progression-free survival was 66.3%. No unexpected toxicities were recorded, and only eight patients suspended from any study drug. Of note, 21 (45.7%) patients reported peripheral neuropathy (PN) (grades 1-2 with no serious adverse events). IRd induction and consolidation with transplant before lenalidomide maintenance shows lower response rates compared to other triplet therapies. It could be an alternative for patients who require an all-oral regimen and/or with pre-existent PN, especially if quadruplet regimens including anti-CD38 antibody are not available., (© 2024 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF