Dr. Hari on the Current and Potential Future Utility of Ixazomib Maintenance in Myeloma

Parameswaran Hari, MD, MRCP, the Armand J. Quick/William F. Stapp Professor of Hematology, and the chief of the Division of Hematology/Oncology, Department of Medicine, at the Medical College of Wisconsin, discusses the current and potential future utility of ixazomib (Ninlaro) maintenance in multiple myeloma.

Lenalidomide (Revlimid) is the gold standard of maintenance therapy in multiple myeloma, says Hari. At the 2020 ASCO Virtual Scientific Program, Meletios A. Dimopoulos, MD, of the University Athens School of Medicine, presented data from the phase 3 TOURMALINE-MM4 trial, showing a significant improvement in progression-free survival with ixazomib maintenance versus placebo. The results showed proof-of-principle that ixazomib has utility as maintenance therapy in myeloma. However, without head-to-head data, the field cannot definitively say whether ixazomib confers an advantage over lenalidomide, explains Hari.

With this in mind, ixazomib could be useful for certain subgroups of patients, such as those who cannot tolerate lenalidomide, those who have progressed on lenalidomide, and those who cannot afford lenalidomide, says Hari. Moreover, ixazomib could potentially be used in combination with lenalidomide, particularly for patients with high-risk disease.