{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:53:33Z","timestamp":1776336813153,"version":"3.51.2"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Ixazomib, lenalidomide, and dexamethasone (IRd) have been approved for the treatment of relapsed\/refractory multiple myeloma (RRMM) based on the results of the TOURMALINE\u2010MM1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives and Methods<\/jats:title><jats:p>We conducted a retrospective\u2013prospective analysis of 106 RRMM patients (pts) treated with IRd in 21 centers in Northern Italy, with the aim to evaluate the efficacy and safety of IRd in real life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At IRd initiation, 34% of pts were aged \u226575 (median 72.5), 8.5% had an ECOG performance status \u22652, 54.7% of evaluable pts carried high\u2010risk cytogenetic abnormalities [del17p and\/or t(4;14) and\/or t(14;16) and\/or 1\u2009g gain\/amp], 60.2% had received \u22652 prior lines of therapy (pLoT), 57.5% were lenalidomide (Len)\u2010exposed (including both Len\u2010sensitive and Len\u2010refractory pts), and 22% were Len\u2010refractory. Main G \u22653 adverse events (AEs) were thrombocytopenia (16%) and neutropenia (12.3%). G \u22653 non\u2010hematologic AEs included infections (9.4%) and GI toxicity (diarrhea 5.7%, hepatotoxicity 2.8%), VTE, skin rash, and peripheral neuropathy were mainly G1\u20102. The overall response rate was 56.4% (\u2265VGPR 30%). With a median follow\u2010up of 38\u2009m, median PFS (mPFS) was 16\u2009m and the 1\u2010year OS rate was 73%. By subgroup analysis, an extended PFS was observed for pts achieving \u2265VGPR (mPFS 21.2\u2009m), time from diagnosis to IRd \u22655\u2009years (26.2\u2009m), 1 pLoT (34.4\u2009m), Len\u2010na\u00efve (NR), age \u226570 (20\u2009m). In pts exposed to Len, non\u2010refractory in any prior line and immediately prior to IRd, mPFS was 16 and 18\u2009m, respectively. An inferior PFS was seen in Len\u2010refractory pts (4.6\u2009m). By multivariate analysis, independent predictors of PFS were age \u226570 (HR 0.6), time from diagnosis \u22655\u2009years (HR 0.32), refractoriness to Len in any prior line (HR 3.33), and immediately prior (HR 4.31).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IRd might be effective and safe in RRMM pts with an indolent disease, in early lines of treatment, and who proved Len\u2010sensitive, independent of age, and cytogenetic risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7071","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T12:10:16Z","timestamp":1711973416000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A real\u2010world retrospective\u2013prospective analysis of efficacy and safety of combined ixazomib, lenalidomide, and dexamethasone in relapsed\/refractory multiple myeloma: The northern Italy experience"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6443-3241","authenticated-orcid":false,"given":"Anna","family":"Furlan","sequence":"first","affiliation":[{"name":"Divisione di Ematologia Ospedale Ca' Foncello di Treviso, ASL 2  Treviso Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Cea","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Internal Medicine (DiMI) University of Genoa, IRCSS Ospedale Policlinico San Martino  Genova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Pavan","sequence":"additional","affiliation":[{"name":"Padua University School of Medicine Hematology and Clinical Immunology  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Galli","sequence":"additional","affiliation":[{"name":"Hematology Division, Ospedale Papa Giovanni XXIII  Bergamo 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