Ixazomib-Lenalidomide-Dexamethasone for the Treatment of Relapsed/Refractory Multiple Myeloma - A Hungarian Real-World Analysis

Sep 30, 2026

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Despite therapeutic advances, managing relapsed/refractory multiple myeloma remains challenging, especially for patients with frailty, comorbidities, mobility limitations, or when preference and drug accessibility are key. A multicenter retrospective analysis evaluated Hungary-based IRd (ixazomib–lenalidomide–dexamethasone) use from 1 January 2020 to 30 June 2025. Median PFS was 18.7 months and OS 34.7 months, with longer PFS for biochemical versus clinical progression. Treatment-related adverse events occurred in 68.3% of patients, supporting IRd as an effective all-oral option.

LanguageEnglish

CategoryHealthcare

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Pages13

Reading Time33 min

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Abstract

Background/Objectives

Methods

Results

Conclusions

Introduction

Article Ixazomib-Lenalidomide-Dexamethasone for the Treatment of Relapsed/Refractory Multiple Myeloma: A Hungarian Real-World Analysis Hermina Sánta 1, Laura Regáli 2, László Váróczy 3, Virág Szita 4, Ádám Wiedemann 4, Lóránt Varju 5, László Rejt ˝o 5, Norbert Sándor Bartha 5, Dorottya Máté 6, András Masszi 6, Márk Plander 7, Szabolcs Kosztolányi 8, Alizadeh Hussain 8, Piroska Pettendi 9, Ildikó Istenes 10, Árpád Szomor 1, Péter Reményi 2, Tamás Masszi 4, Gergely Varga 4,† and Gábor Mikala 4, *,† Academic Editor: IoannisNtanasisStathopoulos Received: 1 December 2025 Revised: 24 December 2025 Accepted: 26 December 2025 Published: 30 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 3rd Department of Internal Medicine, Hematology Fejér County University Hospital, 8000 Székesfehérvár, Hungary; [dr.santa.hermina@gmail.com](dr.santa.hermina@gmail.com) (H.S.); [aszomor2@mail.fmkorhaz.hu](aszomor2@mail.fmkorhaz.hu) (Á .S.) 2 National Institute for Haematology and Infectious Diseases, South-Pest Central Hospital, 1097 Budapest, Hungary; [laura.julia.regali@gmail.com](laura.julia.regali@gmail.com) (L.R.); [premenyi@dpckorhaz.hu](premenyi@dpckorhaz.hu) (P.R.) 3 Department of Hematology, Institute for Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; [laszlo.varoczy@gmail.com](laszlo.varoczy@gmail.com) 4 Department of Internal Medicine and Hematology, Semmelweis University, 1088 Budapest, Hungary; [virag.szita@gmail.com](virag.szita@gmail.com) (V.S.); [wiedemannadam@gmail.com](wiedemannadam@gmail.com) (Á .W.); [masszi.tamas@semmelweis.hu](masszi.tamas@semmelweis.hu) (T.M.); [vargager@gmail.com](vargager@gmail.com) (G.V.) 5 Department of Hematology, Szabolcs-Szatmár-Bereg County Hospital, 4400 Nyíregyháza, Hungary; [varjulorant@gmail.com](varjulorant@gmail.com) (L.V.); [lrejto@med.unideb.hu](lrejto@med.unideb.hu) (L.R.); [drbnorbs@gmail.com](drbnorbs@gmail.com) (N.S.B.) 6 Department of Hematology, National Institute of Oncology, 1122 Budapest, Hungary; [mate.dorottya@oncol.hu](mate.dorottya@oncol.hu) (D.M.); [amasszi@gmail.com](amasszi@gmail.com) (A.M.) 7 Department of Hematology and Hemostaseology, Vas County Markusovszky University Hospital, 9700 Szombathely, Hungary; [planderm@yahoo.com](planderm@yahoo.com) 8 First Department of Internal Medicine, University of Pécs-Clinical Centre, 7624 Pécs, Hungary; [kosztolanyi.szabolcs@pte.hu](kosztolanyi.szabolcs@pte.hu) (S.K.); [alizadeh.hussain@gmail.com](alizadeh.hussain@gmail.com) (A.H.) 9 Department of Hematology, Jász-Nagykun-Szolnok County Géza Hetényi Hospital, 5000 Szolnok, Hungary; [piri.pet@gmail.com](piri.pet@gmail.com) 10 Department of Internal Medicine and Oncology, Semmelweis University, 1083 Budapest, Hungary; [istildi78@gmail.com](istildi78@gmail.com) * [Correspondence: mikala.gabor@semmelweis.hu](Correspondence: mikala.gabor@semmelweis.hu)[ ](Correspondence: mikala.gabor@semmelweis.hu)† These authors contributed equally to this work. Abstract Background/Objectives: Despite therapeutic advances, managing relapsed/refractory multiple myeloma (RRMM) remains challenging. For patients with frailty, comorbidities, mobility limitations, or when treatment preference and drug accessibility are key considerations, the all-oral ixazomib–lenalidomide–dexamethasone (IRd) regimen offers a practical alternative. Methods: We performed a multicenter retrospective study of RRMM patients treated with IRd in Hungary between 1 January 2020 and 30 June 2025 . Results: The median age at treatment initiation was 73.7 years. Treatment was initiated for clinical progression in 38.2%, biochemical progression in 53.3%, and for intolerance or toxicity of prior therapy in 8.6% . Median progression-free survival (PFS) was 18.7 months, and median overall survival (OS) was

FAQs

Why was the IRd all-oral regimen considered for relapsed/refractory multiple myeloma patients?

The regimen offers a practical alternative when patients have frailty, comorbidities, mobility limitations, or when treatment preference and drug accessibility are important considerations.

What were the key efficacy outcomes reported for IRd in Hungary?

Median progression-free survival was 18.7 months and median overall survival was 34.7 months; in the second-line setting, median PFS was 24.5 months and median OS was not reached.

How did outcomes differ between clinical progression and biochemical progression?

Patients treated at biochemical progression had significantly longer PFS than those treated at clinical progression (24.3 vs 15.6 months, p = 0.004). Additional benefit was reported when IRd began due to intolerance or toxicity of prior therapy (p = 0.04).

Sep 30, 2026

Uploaded by Ben