Comparative Effectiveness and Safety of PI-Rd Triplets in Relapsed/Refractory Multiple Myeloma: INSIGHT-MM Data
Noemi Puig1, Xavier Leleu2, Hans C Lee3
1University Hospital of Salamanca, Salamanca, Spain.
European Journal of Haematology
|January 13, 2026
Summary
Ixazomib, carfilzomib, or bortezomib plus lenalidomide-dexamethasone (Rd) triplets show similar effectiveness and safety in relapsed/refractory multiple myeloma (RRMM). Treatment decisions should consider individual patient needs for optimal outcomes.
Area of Science:
- Hematology
- Oncology
- Clinical Research
Background:
- Relapsed/refractory multiple myeloma (RRMM) presents treatment challenges.
- Proteasome inhibitors (PIs) combined with lenalidomide-dexamethasone (Rd) are treatment options for RRMM.
- Real-world data is crucial for understanding treatment effectiveness beyond clinical trials.
Purpose of the Study:
- To evaluate the real-world effectiveness and safety of three PI-based triplet regimens (IRd, KRd, VRd) in RRMM patients.
- To compare these regimens in a second or later line of therapy (LoT).
- To inform clinical decision-making for RRMM treatment selection.
Main Methods:
- Observational study using data from the INSIGHT-MM study (NCT02761187).
- Included adult patients with RRMM receiving IRd, KRd, or VRd in ≥2nd LoT.
- Assessed progression-free survival (PFS) using Kaplan-Meier and Cox models; safety data were descriptively reported.
Main Results:
- 356 treatment lines from 348 patients were analyzed.
- Median real-world PFS (rwPFS) was 14.5 months for IRd, 13.2 for KRd, and 9.1 for VRd.
- Adjusted analyses showed no significant rwPFS differences between regimens; all had manageable safety profiles.
Conclusions:
- Ixazomib-Rd (IRd), carfilzomib-Rd (KRd), and bortezomib-Rd (VRd) demonstrate comparable real-world effectiveness and safety in RRMM.
- These findings support individualized treatment selection based on patient needs.
- Real-world data provides valuable insights into PI triplet efficacy in RRMM management.
