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Approval was based on the global, randomised, double\u2010blind, placebo\u2010controlled Phase <jats:styled-content style=\"fixed-case\">III TOURMALINE<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>1 study of ixazomib\u2010Rd (<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>d) versus placebo\u2010Rd in patients with relapsed\/refractory multiple myeloma. <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>d resulted in a significant improvement in progression\u2010free survival versus placebo\u2010Rd (median: 20\u00b76 vs. 14\u00b77\u00a0months; hazard ratio 0\u00b774). Common toxicities observed more commonly with <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>d versus placebo\u2010Rd were thrombocytopenia, nausea, vomiting, diarrhoea, constipation, rash, peripheral neuropathy, peripheral oedema and back pain; these were generally grade 1\/2 in severity except for thrombocytopenia (19% vs. 9% grade 3\/4), which appeared manageable and reversible, with no differences between arms in significant bleeding or dose discontinuations. No cumulative toxicities were observed, indicating the potential feasibility of long\u2010term <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>d treatment. Safety data from <jats:styled-content style=\"fixed-case\">TOURMALINE<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>1 are reviewed and guidance for managing clinically relevant adverse events associated with <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>d is provided. Most toxicities were manageable with supportive care and dose delays or reductions as needed. Clinicians should be aware of and understand these potential side effects to optimise and prolong patient benefit.<\/jats:p>","DOI":"10.1111\/bjh.14733","type":"journal-article","created":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T05:52:41Z","timestamp":1494309161000},"page":"571-582","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Management of adverse events associated with ixazomib plus lenalidomide\/dexamethasone in relapsed\/refractory multiple myeloma"],"prefix":"10.1111","volume":"178","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5392-9284","authenticated-orcid":false,"given":"Shaji","family":"Kumar","sequence":"first","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1780-8746","authenticated-orcid":false,"given":"Philippe","family":"Moreau","sequence":"additional","affiliation":[{"name":"University Hospital H\u00f4tel Dieu Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parameswaran","family":"Hari","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Froedtert Hospital and the Medical College of Wisconsin Milwaukee WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria\u2010Victoria","family":"Mateos","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda Hospital Universitario de Salamanca Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Wilhelminenspital der Stadt Wien Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaim","family":"Shustik","sequence":"additional","affiliation":[{"name":"McGill University Health Center Royal Victoria Hospital Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamas","family":"Masszi","sequence":"additional","affiliation":[{"name":"Department of Haematology and Stem Cell Transplantation St Istv\u00e1n and St L\u00e1szl\u00f3 Hospital Semmelweis University Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Spencer","sequence":"additional","affiliation":[{"name":"Alfred Health\u2010Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"H\u00e1jek","sequence":"additional","affiliation":[{"name":"Department of Haematooncology University Hospital Ostrava Ostrava Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Romeril","sequence":"additional","affiliation":[{"name":"Wellington Blood and Cancer Centre Wellington Regional Hospital Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irit","family":"Avivi","sequence":"additional","affiliation":[{"name":"Department of Haematology and Bone Marrow Transplantation Tel Aviv Medical Centre Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Liberati","sequence":"additional","affiliation":[{"name":"University of Perugia SC Oncoematologia AO S. 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