{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:22:34Z","timestamp":1747149754723,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"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":["eJHaem"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Ixazomib\u2010lenalidomide\u2010dexamethasone (ixazomib\u2010Rd) showed clinical efficacy over placebo\u2010Rd in patients with relapsed\/refractory multiple myeloma (MM) in the TOURMALINE\u2010MM1 trial. Over a median follow\u2010up of \u223c85\u00a0months, as patients showed disease progression, they received subsequent novel therapies that confounded the overall survival (OS) benefit. Here, we conducted a post hoc analysis in 148 patients from seven countries defined as emerging markets, with limited access to novel therapies for MM during the trial period, to describe the impact of these therapies on OS. Patients were randomised to ixazomib\u2010Rd (<jats:italic>n<\/jats:italic> = 71) or placebo\u2010Rd (<jats:italic>n<\/jats:italic> = 77). The median progression\u2010free survival (PFS) was 18.7 versus 10.2\u00a0months, with ixazomib\u2010Rd versus placebo\u2010Rd (hazard ratio [HR], 0.504; <jats:italic>p<\/jats:italic> = 0.008) demonstrating a statistically significant improvement as observed in the primary trial. The median OS improved by 32.6\u00a0months with ixazomib\u2010Rd over placebo\u2010Rd (63.5 vs. 30.9\u00a0months; HR, 0.794; <jats:italic>p<\/jats:italic> = 0.261); however, the statistically significant benefit seen in PFS was not observed for OS. Improvement with ixazomib\u2010Rd over placebo\u2010Rd was observed in overall response (81.7% vs. 64.9%; odds ratio [OR], 2.38; <jats:italic>p<\/jats:italic> = 0.019) and complete response (22.5% vs. 3.9%; OR, 7.57; <jats:italic>p<\/jats:italic> &lt; 0.001). Patient\u2010reported quality of life and use of subsequent therapies were similar across treatment groups. No new safety concerns were identified. Compared with the main cohort, median OS was 10\u00a0months longer with ixazomib\u2010Rd and 21\u00a0months shorter with placebo\u2010Rd in this subgroup, indicating a clinically meaningful survival benefit of ixazomib\u2010Rd treatment in this patient population with limited access to subsequent novel therapies.<\/jats:p>","DOI":"10.1002\/jha2.548","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T03:43:50Z","timestamp":1662003830000},"page":"1241-1251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of ixazomib\u2010lenalidomide\u2010dexamethasone therapy on overall survival in multiple myeloma patients: Analysis of the emerging\u2010markets subgroup of the TOURMALINE\u2010MM1 trial"],"prefix":"10.1002","volume":"3","author":[{"given":"Andrew","family":"Spencer","sequence":"first","affiliation":[{"name":"The Alfred Hospital\u2010Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Samoilova","sequence":"additional","affiliation":[{"name":"State Budget Institution of Healthcare of Nizhny Novgorod Region Nizhny Novgorod Regional Clinical Hospital  Nizhny Novgorod Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wee\u2010Joo","family":"Chng","sequence":"additional","affiliation":[{"name":"National University Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Labotka","sequence":"additional","affiliation":[{"name":"Takeda Development Center Americas  Lexington Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong","family":"Li","sequence":"additional","affiliation":[{"name":"Takeda Development Center Americas  Lexington Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwang\u2010Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Takeda Pharmaceuticals International AG  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nakul","family":"Saxena","sequence":"additional","affiliation":[{"name":"Takeda Pharmaceuticals International AG  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Yan","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Gachon University Gil Medical Center  Namdong\u2010gu South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4487-4004","authenticated-orcid":false,"given":"Meral","family":"Beksac","sequence":"additional","affiliation":[{"name":"Department of Hematology Ankara University School of Medicine  Dikimevi Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33762"},{"key":"e_1_2_11_3_1","unstructured":"The Global Cancer Observatory.Globocan multiple myeloma factsheet. World Health Organization; Lyon France: International Agency for Research on Cancer;2020.https:\/\/gco.iarc.fr\/today\/data\/factsheets\/cancers\/35\u2010Multiple\u2010myeloma\u2010fact\u2010sheet.pdf"},{"key":"e_1_2_11_4_1","unstructured":"The Global Cancer Observatory.Globocan: multiple myeloma. 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