Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Hematology Ohta Clinic, Shinsaibashi, Osaka, Japan.
Eur J Haematol. 2021 Apr;106(4):555-562. doi: 10.1111/ejh.13586. Epub 2021 Jan 31.
This study aimed to investigate real-world data of ixazomib plus lenalidomide and dexamethasone (IRd) therapy for patients with relapsed and refractory multiple myeloma (RRMM).
We retrospectively analyzed 122 patients treated with IRd at 16 centers from May 2017 to January 2019 by using the Kansai Myeloma Forum database.
At the start of IRd, the median age was 72 years, 66.7% of patients had IgG type, and the median number of prior therapies was 4, comprising bortezomib (85.4%) and lenalidomide (89.3%)-based regimens. Disease progression and adverse events accounted for treatment discontinuation in 46 and 32 patients, respectively. The median overall survival (OS) was not reached, and the median progression-free survival (PFS) was 11.9 months. Sensitivity to bortezomib did not affect the PFS, whereas lenalidomide-refractory patients had significantly lower PFS than lenalidomide-sensitive patients, who were comparable to TOURMALINE-MM1 study. The patients with IgG type had significantly better PFS and OS than those with non-IgG type.
This study presents the largest real-world data of patients treated with IRd in Asia. However, in real clinical practice, the patient background is different from the TOURMALINE-MM1 study, and IRd showed poor efficacy, especially in the non-IgG type and lenalidomide-refractory patients with RRMM.
本研究旨在探讨伊沙佐米联合来那度胺和地塞米松(IRd)治疗复发/难治性多发性骨髓瘤(RRMM)患者的真实世界数据。
我们使用关西骨髓瘤论坛数据库,回顾性分析了 2017 年 5 月至 2019 年 1 月在 16 个中心接受 IRd 治疗的 122 例患者。
在开始 IRd 时,患者的中位年龄为 72 岁,66.7%的患者为 IgG 型,中位治疗线数为 4 条,包括硼替佐米(85.4%)和来那度胺(89.3%)为基础的方案。分别有 46 例和 32 例患者因疾病进展和不良事件而停止治疗。中位总生存期(OS)未达到,中位无进展生存期(PFS)为 11.9 个月。硼替佐米敏感性不影响 PFS,而来那度胺耐药患者的 PFS明显低于来那度胺敏感患者,与 TOURMALINE-MM1 研究结果相似。IgG 型患者的 PFS 和 OS 明显优于非 IgG 型患者。
本研究提供了亚洲接受 IRd 治疗患者的最大真实世界数据。然而,在真实的临床实践中,患者背景与 TOURMALINE-MM1 研究不同,IRd 的疗效较差,尤其是在非 IgG 型和来那度胺耐药的 RRMM 患者中。