Ixazomib, pomalidomide and dexamethasone in triple-class exposed multiple myeloma patients - a phase II study
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Multi-class upfront regimens for multiple myeloma (MM) have improved outcomes, yet many patients become either triple-class exposed (TCE) or refractory (TCR) early in their disease course. This is a phase II, investigator initiated, open-label, single-arm, prospective, multicenter study evaluating all-oral Ixazomib-pomalidomide- dexamethasone (IPd) regimen for TCE RRMM patients. Sixty-one patients were enrolled between March 1st 2021 and March 17th 2024. The median age was 74 (range: 53-89) years; 25 (41%) were ≥75 years old. Fiftyseven percent had high-risk cytogenetics (t(4;14), t(14;16), +1q21, del17p(. Twenty-six (43%) patients were frail. Refractoriness rates to bortezomib, lenalidomide and daratumumab were 51%, 85% and 96% respectively. Tripleclass refractory (TCR) rate was 39%. Ninety-seven percent of the patients had ≥1 treatment emergent adverse event (TEAE) and 67% had a TEAE grade ≥3. The rate of Gr ≥3 AE was not increased in frail vs. non-frail patients (p=0.43). Overall response rate (ORR) was 58% (22% very good partial response or better). TCR patients had an ORR of 46% vs. 68% for non-TCR patients (p=0.12). The median progression-free survival was 8.1 (95% CI 3.9-12.3) months and the median overall survival was 30.4 (95% CI 21.5-39.4) months. To conclude, the all-oral IPd regimen for TCE RRMM patients showed high response rates and a manageable safety profile, in a cohort enriched with TCR, elderly and frail patients. (NCT04790474).
Source: Haematologica
Authors: Tamir Shragai, Noa Lavi, Iuliana Vaxman, Moshe E. Gatt, Evgeni Chubar, Chezi Ganzel, Hila Magen, Efrat Luttwak, Moshe Mittelman, Svetlana Trestman, Eyal Lebel, Revital Saban, Vladimir Vainstein, Tsila Zuckerman, Netanel Horowitz, Inna Tzoran, Nurit Horesh, Noa Lowenton-Spier, Natan Melamed, Ilana Pereg, Irit Avivi, Yael C. Cohen
Institutions: Tel Aviv University, Tel Aviv Sourasky Medical Center, Technion – Israel Institute of Technology, Rambam Health Care Campus, Rabin Medical Center, Hebrew University of Jerusalem, Hadassah Medical Center, Emek Medical Center, Shaare Zedek Medical Center, Bikur Cholim Hospital, Sheba Medical Center, Memorial Sloan Kettering Cancer Center
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,157
OpenAlex ID: W7212184133
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