The primary purpose of this research was to understand whether Maintenance therapy prolongs progression-free survival (PFS) in patients with newly diagnosed multiple myeloma (NDMM) not undergoing autologous stem cell transplantation (ASCT). Placebo-controlled TOURMALINE-MM4 study randomly assigned (3:2) patients with NDMM not undergoing ASCT. The primary endpoint was PFS since time of randomization. Patients were randomly assigned to receive ixazomib (n = 425) or placebo (n = 281). The results showed that Ixazomib significantly benefited patients who achieved complete or very good partial response postinduction (median PFS, 25.6 v 12.9 months; HR, 0.586; P < .001). Common any-grade TEAEs included nausea (26.8% v 8.0%), vomiting (24.2% v 4.3%), and diarrhea (23.2% v 12.3%). With ixazomib versus placebo, 36.6% versus 23.2% of patients had grade ≥ 3 treatment-emergent adverse events (TEAEs). Hence as a conclusion, it is evident that Ixazomib maintenance prolongs PFS with no unexpected toxicity in patients with NDMM not undergoing ASCT.

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