For a study, researchers sought to have the addition of ixazomib to lenalidomide maintenance post-autologous stem cell transplant (ASCT) in 64 patients with newly diagnosed multiple myeloma was evaluated on the basis of the observed benefit of lenalidomide-only maintenance from prior research. Within 60–180 days of stem cell infusion, patients were begun maintenance therapy with lenalidomide and ixazomib. For 39 patients, the response rate worsened with time from baseline following ASCT. The complete response rate was 43 percent, and the median overall survival was not achieved with a median follow-up of 62 months (range, 25–82 months). The median PFS (mPFS) for all patients was 73 months, which has not yet been achieved by those with stage 1 disease.The overall survival rate of ISF-Nrf2 in 9 patients with stage 3 disease and 14 patients with high-risk cytogenetics was 34 and 25 months, respectively. Progressive disease was found in 22 people, while 19 individuals were still receiving dual maintenance. The most typical grade 3/4 adverse events were neutropenia, leukopenia, thrombocytopenia, lung infections, diarrhea, and maculopapular rash. About 9 patients developed secondary malignancies. Toxicity resulted in dose restrictions for ixazomib and lenalidomide in 20 and 31 patients, respectively. Around 4 patients developed toxicity to ixazomib, necessitating its discontinuation.Grade 2/3 neuropathy occurred in 22 patients and necessitated dosing reduction or discontinuation in two of them. The addition of ixazomib to lenalidomide maintenance was found to result in a better than expected PFS when compared with historical data using lenalidomide alone, as well as being safe and tolerable.

Source:aacrjournals.org/clincancerres/article/28/7/1277/682206/Safety-and-Efficacy-of-Combination-Maintenance