Proteasome inhibitors (PIs) have been an integral part of treatment for multiple myeloma (MM) over the past decade. Many newer PIs are being evaluated in pre-clinical and clinical setting, with an aim to improve the safety, efficacy and resistance profile of this class of drugs. Ixazomib is the first oral PI with a robust efficacy and favorable safety profile in MM. Areas covered: This review provides an overview of the (i) pharmacology and dosing of ixazomib, (ii) the efficacy and safety data from clinical studies, (iii) highlight the various novel combinations that have been reported, and (iv) give an overview of the ongoing studies with ixazomib. The review aims to provide a broad overview of the drug and compare and contrast it with the currently available alternatives. Expert commentary: The oral formulation of ixazomib makes it unique in the sense that it is an integral part of the only currently approved oral triplet for relapsed/refractory MM that incorporates both a PI and an immunomodulatory agent. The clinical efficacy, ease of administration, tolerability and synergy with other drug classes make ixazomib a valuable arsenal in the increasingly widening therapeutic armamentarium against MM.
Keywords: Oral anti-myeloma therapy; maintenance therapy; novel agent; quality of life; small molecule proteasome inhibitor.