Expert Point of View: Thierry Facon, MD


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S. Vincent Rajkumar, MD

Keep in mind that we may have situations where we can use ixazomib in clinical practice in newly diagnosed patients.

—S. Vincent Rajkumar, MD

Several experts commented that an all-oral regimen would bring convenience to the treatment of myeloma.

Thierry Facon, MD, of Lille University Hospital in France, told The ASCO Post that although ixazomib (Ninlaro) may not be more active than other proteasome inhibitors, “It definitely has convenience on its side. It’s very safe, it’s effective, and it’s extremely convenient.”

Newly Diagnosed Setting

  1. Vincent Rajkumar, MD, Professor of Medicine at the Mayo Clinic, Rochester, commented that he might use ixazomib off-label in some newly diagnosed patients. Whenever possible, he noted, triplets should be used front line, “and it’s in this context that we are looking at ixazomib.”

“What strikes me is that ixazomib has a very simple dosing schedule—three capsules a month—and the side effect profile is outstanding,” said Dr. Rajkumar. In fact, the drug’s tolerability is so good that in the randomized clinical trial setting, “it’s difficult to tell which patient is taking the drug,” he observed.

“Therefore, while ixazomib is approved for previously treated patients, there are some patients who cannot take bortezomib [Velcade]. Perhaps they can’t get to the clinic once a week for their shot, are too frail for intravenous bortezomib, already have neuropathy, or otherwise don’t have access to bortezomib,” he pointed out.

“Whatever the reason,” said Dr. Rajkumar, “keep in mind that we may have situations where we can use ixazomib in clinical practice in newly diagnosed patients.” ■

Disclosure: Drs. Facon and Rajkumar reported no potential conflicts of interest.

 


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Patients with multiple myeloma now have access to an all-oral regimen, with the recent approval of the oral proteasome inhibitor ixazomib (Ninlaro) in previously treated patients. New pairings for the drug in relapsed/refractory and newly diagnosed patients are being studied, with investigators...


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