Ixazomib - the first oral proteasome inhibitor

Leuk Lymphoma. 2019 Mar;60(3):610-618. doi: 10.1080/10428194.2018.1523398. Epub 2019 Jan 7.

Abstract

Ixazomib, as a proteasome inhibitor, inhibits the chymotrypsin-like activity of the β5 subunit of the 20S proteasome. Based on the TOURMALINE-MM1 study, ixazomib was proved by the FDA as the orphan drug in November 2015. With a promising effect in prolonging the progression-free survival compared with placebo treatment (median: 20.6 versus 14.7 months), it was the first oral compound combined with lenalidomide and dexamethasone for the treatment of patients with relapsed/refractory multiple myeloma (RRMM) who have received at least one prior therapy. The main adverse events include low-grade hematological, digestive, or cutaneous events, which were manageable with care. Overall, ixazomib demonstrated favorable safety profile. Ongoing trials are conducted to define its place in first-line, maintenance, and relapse therapies. In this review, we summarized the clinical pharmacology, efficacy, tolerability, safety, and cost-effectiveness of ixazomib.

Keywords: Ixazomib; proteasome inhibitor; relapsed/refractory multiple myeloma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Oral
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / pharmacology*
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Boron Compounds / administration & dosage
  • Boron Compounds / pharmacology*
  • Boron Compounds / therapeutic use*
  • Clinical Trials as Topic
  • Cost-Benefit Analysis
  • Drug Resistance, Neoplasm
  • Glycine / administration & dosage
  • Glycine / analogs & derivatives*
  • Glycine / pharmacology
  • Glycine / therapeutic use
  • Humans
  • Molecular Targeted Therapy
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / mortality
  • Multiple Myeloma / pathology
  • Proteasome Inhibitors / administration & dosage
  • Proteasome Inhibitors / pharmacology*
  • Proteasome Inhibitors / therapeutic use*
  • Recurrence
  • Retreatment
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Boron Compounds
  • Proteasome Inhibitors
  • ixazomib
  • Glycine