NINLARO® (ixazomib) Relapsing Patient Profiles

There are different types of patients with relapsed multiple myeloma who may be appropriate for the NINLARO triplet regimen.*1

*The NINLARO regimen includes NINLARO+lenalidomide+dexamethasone. The Rd regimen included placebo+lenalidomide+dexamethasone.1

Bruce, a hypothetical NINLARO® patient experiencing an indolent first relapse.

Hypothetical patient

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

Diagnosis

  • Diagnosed with multiple myeloma 3.5 years ago; R-ISS stage I

Treatment history

  • 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

Laboratory results

  • 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. 

Alice, a hypothetical NINLARO® patient is an active elderly grandmother at first relapse.

Hypothetical patient

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

Diagnosis

  • Diagnosed with multiple myeloma 2 years ago; R-ISS stage I
  • Patient had a history of hypertension

Treatment history

  • 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

Laboratory results

  • 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.