{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T20:16:16Z","timestamp":1767212176168,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To characterize the impact of prior exposure and refractoriness to lenalidomide or proteasome inhibitors (PIs) on the effectiveness and safety of ixazomib\u2013lenalidomide\u2013dexamethasone (IRd) in relapsed\/refractory multiple myeloma (RRMM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>INSURE is a pooled analysis of adult RRMM patients who had received IRd in \u22652 line of therapy from three studies: INSIGHT MM, UVEA\u2010IXA, and REMIX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 391\/100\/68 were lenalidomide\u2010na\u00efve\/\u2212exposed\/\u2212refractory and 37\/411\/110 were PI\u2010na\u00efve\/\u2212exposed\/\u2212refractory. Median duration of therapy (DOT) was 15.3\/15.6\/4.7\u2009months and median progression\u2010free survival (PFS) was 21.6\/25.8\/5.6\u2009months in lenalidomide\u2010na\u00efve\/exposed\/refractory patients. Median DOT and PFS in PI\u2010na\u00efve\/exposed\/refractory patients were 20.4\/15.2\/6.9\u2009months and not reached\/19.8\/11.4\u2009months, respectively. The proportion of lenalidomide\u2010na\u00efve\/exposed\/refractory patients in INSIGHT and UVEA\u2010IXA who discontinued a study drug due to adverse events (AEs) was ixazomib, 31.6\/28.2\/28.0% and 18.6\/6.7\/10.5%; lenalidomide, 21.9\/28.2\/16.0% and 16.1\/6.7\/10.5%; dexamethasone, 18.4\/20.5\/16.0% and 10.6\/0\/10.5%, respectively. The proportion of PI\u2010na\u00efve\/exposed\/refractory patients in INSIGHT and UVEA\u2010IXA who discontinued a study drug due to AEs was: ixazomib, 44.4\/28.8\/27.8% and 22.2\/16.7\/15.7%; lenalidomide, 33.3\/22.0\/19.4% and 16.7\/15.9\/11.8%; dexamethasone, 33.3\/17.4\/16.7% and 16.7\/9.5\/7.8%, respectively. REMIX AE discontinuation rates were unavailable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IRd appeared to be effective in RRMM patients in routine clinical practice regardless of prior lenalidomide or PI exposure, with better outcomes seen in lenalidomide\u2010 and\/or PI\u2010nonrefractory versus refractory patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.14214","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T06:48:51Z","timestamp":1713941331000},"page":"190-200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of prior lenalidomide or proteasome inhibitor exposure on the effectiveness of ixazomib\u2013lenalidomide\u2013dexamethasone for relapsed\/refractory multiple myeloma: A pooled analysis from the <scp>INSURE<\/scp> study"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8545-3292","authenticated-orcid":false,"given":"Hans C.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Lymphoma\/Myeloma The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3385-3707","authenticated-orcid":false,"given":"Karthik","family":"Ramasamy","sequence":"additional","affiliation":[{"name":"Department of Haematology Oxford University Hospitals NHS Foundation Trust  Oxford Oxfordshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Macro","sequence":"additional","affiliation":[{"name":"CHU de Caen Normandie  Caen France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faith E.","family":"Davies","sequence":"additional","affiliation":[{"name":"Perlmutter Cancer Center, NYU Langone  New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafat","family":"Abonour","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frits","family":"van Rhee","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences (UAMS)  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vania T. 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