Phase II trial of the combination of ixazomib, lenalidomide, and dexamethasone in high-risk smouldering multiple myeloma

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Published: 17 Dec 2018
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Dr Mark Bustoros - Harvard Medical School, Boston, USA

Dr Mark Bustoros speaks to ecancer at ASH 2018 about results from the study into the combination of ixazomib, lenalidomide, and dexamethasone in high-risk smouldering multiple myeloma patients.

He explains that in the 29 patients analysed they saw high complete response rates and he also recognises the convenience for patients as the drug is taken orally.

Dr Bustoros believes that these results are very promising for a group at high risk of progression.

What we are presenting this year is a phase II clinical trial, an interim analysis of the combination of ixazomib, Revlimid and dexamethasone in high risk smouldering multiple myeloma patients. This is a study I work on with Dr Irene Ghobrial, the Principal Investigator of this study, and it’s part of the efforts of the Centre for Prevention of Progression of Blood Cancers at Dana Farber Cancer Institute. This is an interim analysis of 29 patients of the 57 patients that are accrued in the study.

Basically the standard of care of smouldering myeloma patients is still to observe and just follow them up, however, there are patients who are at a high risk of progression to multiple myeloma and multiple myeloma is still an incurable blood cancer. So we tried the idea of early prevention and if these patients would benefit from an early intervention approach, either to prevent progression from happening or maybe even if we can achieve cure in the future for them.

What did you look at?

In the 29 patients that we analysed the response rates actually were very high compared in means of complete responses and very good partial responses of almost 55% of these patients. At the same time this combination is oral so it’s not an infusion so it’s also very convenient for patients who are asymptomatic but still at a high risk of progression. They just come once a month, get their pills and have bloodwork to assess their response but it’s very convenient for them. In means of side effects and toxicity most of the side effects were grade 1 and 2, very few grade 3 and 4 side effects.

What are your conclusions and any implications?

We concluded that in this interim analysis of 29 patients high response rates in means of complete response and very good partial response is very promising for this patient group who are at a high risk of progression. Also the convenience of this regimen, in means that it’s an oral regimen, is also very promising that we can expand more on larger studies in high risk smouldering patients for the aim that we can prevent progression from happening or even achieve a cure in the future.