The NINLARO triplet regimen could help Bruce—
the TOURMALINE-MM1 trial evaluated the efficacy and safety of the all-oral NINLARO regimen, demonstrating prolonged PFS vs Rd regimen.*1,2
Bruce • 58 years old • Experiencing an indolent first relapse
Bruce is experiencing limited clinical symptoms, and his M protein levels have been increasing slowly over the past 4 months.
Reason for clinic visit
- Follow-up visit
- Limited bone pain and aches
- Diagnosed with multiple myeloma 3.5 years ago; R-ISS stage I
- First line of therapy was PI+immunomodulator+steroid for 4 cycles, and this was followed by ASCT
- Patient achieved a VGPR
- Receiving immunomodulator therapy for 2 years at a suboptimal dosage†
- ECOG PS: 0
- Hemoglobin: 11.7 g/dL
- Serum creatinine: 0.9 mg/dL
- Serum calcium: 10.3 mg/dL
- Serum M protein:
- June: 1.1 g/dL
- July: 1.3 g/dL
- August: 1.6 g/dL
- Skeletal imaging: no new lytic lesions detected
- Cytogenetics/FISH: no adverse cytogenetics
†Bruce is not lenalidomide refractory.
ASCT=autologous stem cell transplant; ECOG PS=Eastern Cooperative Oncology Group performance status; FISH=fluorescence in situ hybridization; PI=proteasome inhibitor; R-ISS=revised International Staging System; VGPR=very good partial response.
The NINLARO triplet regimen could help Alice—
NINLARO has data from real-world studies whose participants reflect patients seen in clinical practice.1-6
Alice • 75 years old • Active elderly grandmother at first relapse
Alice has been experiencing relapse symptoms, so her physician is considering a triplet regimen.
Reason for clinic visit
- Patient has been experiencing new-onset back pain and generalized fatigue
- Diagnosed with multiple myeloma 2 years ago; R-ISS stage I
- Patient had a history of hypertension
- Initially treated with an injectable PI+immunomodulator+steroid regimen
- Treated for 9 months, achieved best response of VGPR
- Continued treatment with immunomodulator+steroid as maintenance therapy in a suboptimal dosage‡
- ECOG PS: 1
- Hemoglobin: 9.5 g/dL
- Serum creatinine: 1.1 mg/dL
- Serum calcium: 10.5 mg/dL
- Serum M protein: 1.2 g/dL
- Skeletal imaging: one new lytic lesion
- Cytogenetics/FISH: negative for high-risk features
‡Alice is not lenalidomide refractory.
ECOG=Eastern Oncology Cooperative Group performance status; FISH=fluorescence in situ hybridization; PI=proteasome inhibitor; R-ISS=revised International Staging System; VGPR=very good partial response.
Treatment trends in multiple myeloma
Proteasome inhibition remains a cornerstone of multiple myeloma treatment with optimal outcomes.
NINLARO real-world studies
Real-world evidence can complement data from clinical trials.
NINLARO safety profile
The NINLARO regimen: a PI triplet with safety similar to the Rd regimen.