• Multiple Myeloma News
    • Nov 14, 2019

    Ninlaro Extends Survival as Maintenance Therapy for Transplant Ineligible Patients


Phase III results of a recent study (TOURMALINE-MM4) show that Ninlaro (ixazomib) can prolong survival when used as maintenance therapy for multiple myeloma patients who are not fit enough to receive a stem cell transplant. Ninlaro is in a class of drugs called proteasome inhibitors.

Revlimid (lenalomide), an immumomodulator, is commonly used in today’s myeloma clinic as maintenance therapy. The results of this study show that Ninlaro as an additional maintenance therapy option may also be helpful. 

Study authors reviewed data from four different Ninlaro studies for 706 newly diagnosed myeloma patients where they received induction therapy with once or twice-weekly ixazomib plus one of the following combinations:

  • Lenalidomide/dex (IRd)
  • Melphalan/prednisone (IMP)
  • Cyclophosphamide/dex (Icd)


Patients were then given only ixazomib as maintenance therapy until disease progression. A total of 121 patients achieved stable disease or better after their initial myeloma treatment: 

  • Once weekly IRD = 25 patients
  • Twice weekly IRD – 18 patients
  • Once or twice weekly IMP = 35 patients
  • Weekly ICD  = 43 patients


About 22% of the myeloma patients had a complete response after their initial therapy. A total of 28 patients (23%) improved their response during maintenance. After maintenance therapy, that number grew to 35%. Study authors noted: 

“There is increasing evidence for the clinical benefit of long-term, continuous therapy in patients with newly diagnosed multiple myeloma, irrespective of whether they undergo autologous stem cell transplantation.” 

Maintenance therapy is typically a lower dose of medication for an extended period of time and for many myeloma patients, it can extend their remissions considerably. We’ll learn more at the upcoming ASH 2019 meeting in Orlando about this convenient and oral option. 

About Author

Jenny A

Myeloma survivor, patient advocate, wife, mom of 6. Believer that patients can help accelerate a cure by weighing in and participating in clinical trials. Founder of Myeloma Crowd, Myeloma Crowd Radio and the CrowdCare Foundation.


  1. PAUL SELBY November 15, 2019 at 7:52 am

    Hello Jenny, My name is Paul Selby from Nottingham, England. I was diagnosed with myeloma in 2016, underwent stem cell transplant in November that year, relapsed May 2018. Couldn’t have a second transplant as hospital had accidentally administered all 7m stem cells at first transplant! A second attempt at harvesting Dec 2018 failed. Received four cycles of Velcade/Cyclo/Dex prior to and post harvest attempt. Treatment completed May this year with a protein count of 7. Been off treatment since with protein count ticking up approx 1 every 6 weeks, reaching 13 a couple of weeks ago. At 14 or 15 treatment will recommence with Revolimid and Ixazomib (plus Dex!) so really interested to read the article on Ninlaro. During this treatment free period, I have been taking 8 grammes of Curcumin (4 am and 4 pm with food) but whether this is having any effect on the myeloma I don’t know!
    Thank you for Myeloma Crowd – it is really good to see what is happening globally as well as locally via Myeloma UK.

    • Jenny A
      Jenny A November 15, 2019 at 10:22 am

      Thanks Paul! I hope your new treatment will be very effective. If you want to join http://www.healthtree.org you will be able to see (shortly) other patients in similar situations and there will be an entire HealthTree University to help you learn more about myeloma. It would be fascinating to see differences between the countries.

  2. Doug Steinmeyer November 20, 2019 at 11:09 am

    I have been on a Ninlaro trial for five years after a loss of remission from two stem cell transplants.
    The Ninlaro plus Dex plus cytoxin do the trick.
    No M spike for the last three years. I am grateful for doctors and my Lord Jesus that I have been given the opportunity to live this long and in great health.

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