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Updated: Aug 15, 2025
An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Network meta-analysis of efficacy of ixazomib, lenalidomide, and dexamethasone in relapsed/refractory multiple
Maral DerSarkissian1, Holly Cranmer2, Jonathan Dabora3
1Analysis Group, Boston, MA, USA.
Objectives:
In the absence of head-to-head comparisons across relapsed/refractory multiple myeloma (RRMM) treatments following the approval of the oral proteasome inhibitor ixazomib, in combination with lenalidomide and dexamethasone (IRd), we conducted an indirect comparison of the efficacy of IRd relative to several RRMM therapies using Bayesian fixed-effects network meta-analysis (NMA) models.
Methods:
Data for the NMA were obtained through a systematic literature review (conducted in June 2020), which identified randomized controlled trials (base case) and observational studies (extended network analysis) reporting overall survival (OS), progression-free survival (PFS), and overall response rate (ORR).
Results:
In the base case, IRd was associated with a significantly longer PFS than lenalidomide and dexamethasone (Rd), bortezomib monotherapy (V), dexamethasone (Dex), and pomalidomide and dexamethasone (Pom-dex), a significantly shorter PFS than daratumumab, lenalidomide, and dexamethasone (DRd), and a PFS comparable to elotuzumab, lenalidomide, and dexamethasone (ERd) and carfilzomib, lenalidomide, and dexamethasone (KRd). IRd was associated with a significantly longer OS than V, Dex, and Pom-dex, and an OS comparable to Rd, ERd, KRd, and DRd. The ORR of IRd was significantly higher than Rd, V, and Dex, significantly lower than KRd and DRd, and comparable to Pom-dex and ERd. The extended network analyses and sensitivity analyses were consistent with the base case.
Discussion:
This NMA shows that IRd is relatively efficacious among RRMM treatments. Being an oral regimen, IRd is also convenient to manage.
Conclusion:
IRd could be a preferable treatment option for many patients with RRMM, particularly those seeking an efficacious and convenient therapeutic option.
Insights
Ixazomib, lenalidomide, and dexamethasone (IRd) shows efficacy in relapsed/refractory multiple myeloma (RRMM). This oral regimen offers a convenient and effective treatment option for patients.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Relapsed/refractory multiple myeloma (RRMM) presents limited treatment options.
- The oral proteasome inhibitor ixazomib, in combination with lenalidomide and dexamethasone (IRd), is a notable therapeutic advance.
- Head-to-head comparisons for RRMM treatments post-IRd approval are lacking.
Purpose of the Study:
- To conduct an indirect comparison of the efficacy of IRd relative to other RRMM therapies.
- To evaluate overall survival (OS), progression-free survival (PFS), and overall response rate (ORR) of IRd versus other treatments.
Main Methods:
- Bayesian fixed-effects network meta-analysis (NMA) models were employed.
- A systematic literature review identified randomized controlled trials and observational studies.
- Data analysis included base case (RCTs) and extended network analyses.
Main Results:
- IRd demonstrated significantly longer PFS compared to lenalidomide and dexamethasone (Rd), bortezomib (V), dexamethasone (Dex), and pomalidomide and dexamethasone (Pom-dex).
- IRd showed comparable PFS to elotuzumab, lenalidomide, and dexamethasone (ERd) and carfilzomib, lenalidomide, and dexamethasone (KRd), but shorter PFS than daratumumab, lenalidomide, and dexamethasone (DRd).
- IRd exhibited significantly longer OS than V, Dex, and Pom-dex, with comparable OS to Rd, ERd, KRd, and DRd. ORR was higher than Rd, V, and Dex, lower than KRd and DRd, and comparable to Pom-dex and ERd.
Conclusions:
- The NMA indicates that IRd is a relatively efficacious treatment for RRMM.
- The oral administration of IRd offers convenience in patient management.
- IRd represents a potentially preferable treatment option for RRMM patients seeking efficacy and convenience.
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