Cross Q&A: Clinical Application of Ixa-Len-Dex for Patients With MM

EP: 1.Team Introductions: MM Experts From Karmanos Cancer Institute and Cleveland Clinic

EP: 2.ALLIANCE A061202: Ixazomib Plus Pomalidomide and Dexamethasone in Multiple Myeloma

EP: 3.Cross Q&A: Treatment Considerations for Ixa-Pom-Dex in Multiple Myeloma

EP: 4.CARTITUDE-4: Cilta-Cel in Lenalidomide-Refractory MM

EP: 5.Cross Q&A: Efficacy of CAR T-Cell Therapy in MM

EP: 6.Outcomes After Biochemical or Clinical Progression in Patients with MM

EP: 7.Cross Q&A: Retrospective Study of Patients With MM

EP: 8.REMIX: Real-World Effectiveness of Ixazomib with Lenalidomide and Dexamethasone in MM

Now Viewing

EP: 9.Cross Q&A: Clinical Application of Ixa-Len-Dex for Patients With MM

EP: 10.DREAMM-3: Belantamab Mafodotin in Patients With Relapsed/Refractory MM

EP: 11.Treatment Updates and Key Highlights in Multiple Myeloma and CML

EP: 12.Cross Q&A: Role of Belantamab Mafodotin in MM

Transcript:

Craig Cole, MD: Faiz, where do you think you’d use a regimen like this? I think this was a French study done a few years ago. How do you think this fits into the landscape these days?

Faiz Anwer, MD, FACP: I think this fits in with the more frail or [older] patients. A significant number of patients are not close to a major academic center. There’s a significant number of patients who don’t want to travel so frequently. They don’t want to be tied to a center where they have to come back for weekly therapy or injectable therapies. So I think it’s a good option in the second and third lines, where I will likely not use it in the fourth line or after that.

Craig Cole, MD: Did they have a frail vs non-frail analysis in this study?

Faiz Anwer, MD, FACP: This is a paper that was published in the American Society of Hematology, and I don’t think that there was a specific analysis on that. But a significant number of these patients are frail and older, aged 75 or 80 [years] plus. I think, in the practical sense, having the flexibility of reducing the dose without compromising the efficacy of the regimen has a space in our practice.

Jeffrey Zonder, MD: Craig, they did look at PFS[progression-free survival] in patients [older than] 80 [years] vs patients younger than that. And the PFS was similar. It was different by a few months. But it was quite similar. The patients [older than 80 years] had a PFS in this particular paper of about 17 months.

Craig Cole, MD: The ENSURE-1 trial [NCT05134441], which was the pooled analysis of the 3 big European IXA [ixazomib] trials, did have a frail vs nonfrail analysis…. It said the frail [patients] did a bit worse than the nonfrail patients, but that’s no big surprise because it’s always harder to treat our frail over our nonfrail patients.

Jeffrey Zonder, MD: I’m thinking, just to get back to the question you asked before, Craig, about where might you use this regimen.

I’m just thinking about how we [treat patients on the front line]. Maybe in a patient who, for one reason or another, ended up on Dara [daratumumab] maintenance after whatever their induction was. So a Dara monotherapy maintenance, where they haven’t had Revlimid [lenalidomide] and they haven’t had a proteasome inhibitor in a long time, and then they’re progressing. And you want to come back with an IMiD [immunomodulatory drug] and a proteasome inhibitor combo. And for whatever reason you would prefer this over Pom [pomalidomide] CAR [chimeric antigen receptor T-cell therapy]. For a frail patient who has been on Dar maintenance and [has relapsed], this might be a reasonable option.

Transcript is AI-generated and edited for clarity and readability.