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Doctors have reported that the investigational drug ixazomib which can be taken orally in combination with Revlimid (lenalidomide) and dexamethasone shows promise for the treatment of patients with newly diagnosed multiple myeloma, according to the results of a study published in TheLancet Oncology.

Multiple myeloma is a cancer of plasma cells. Plasma cells are a special type of white blood cell that are part of the body’s immune system. Plasma cells normally live in the bone marrow and make proteins, called antibodies, which circulate in the blood and help fight certain types of infections. Plasma cells also play a role in the maintenance of bone by secretion of a hormone called osteoclast activating factor, which causes the breakdown of bone. Patients with multiple myeloma have increased numbers of abnormal plasma cells that may produce increased quantities of dysfunctional antibodies detectable in the blood and/or urine. These abnormal antibodies are referred to as paraproteins or monoclonal proteins in the blood (M proteins) or urine (Bence Jones protein).

Velcade was the first in a new class of anticancer agents known as proteasome inhibitors to be approved for the treatment of multiple myeloma1 and has become a standard of care as part of initial treatment. Velcade, Revlimid, and dexamethasone are highly effective treatments for newly diagnosed multiple myeloma. Ixazomib is an investigational, oral proteasome inhibitor that also has promising anti-myeloma effects and low rates of peripheral neuropathy. Substituting ixazomib for Velcade allows for the creation of an oral drug regimen with it potential for improved patient convenience.

The current study was designed to study the safety, tolerability and activity of ixazomib in combination with Revlimid, and dexamethasone in newly diagnosed multiple myeloma. Physicians at The Mayo Clinic enrolled 65 patients between November 2010 and February 2012 on a clinical trial evaluating the oral regimen. The therapy was generally well tolerated and 92% of patients experienced at least a partial disappearance of their cancer.

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The all-oral combination results support the development of a clinical trial to directly compare the oral to the intravenous combination for multiple myeloma.

Reference: Kumar S, Berdeja J, Niewsvizky R, et al. Safety and tolerability of ixazomib, an oral proteasome inhibitor, in combination with lenalidomide and dexamethasone in patients with previously untreated multiple myeloma: an open-label phase 1/2 study. The Lancet Oncology, Volume 15, Issue 13, Pages 1503 – 1512. December 2014.