{"entity":{"id":"ixazomib","kind":"drug","name":"Ixazomib","aka":[],"tldr":"Ixazomib (Ninlaro) is the first oral proteasome inhibitor for multiple myeloma, enabling an all-oral triplet with lenalidomide and dexamethasone.","summary":"Ixazomib is an oral boronate proteasome inhibitor that reversibly blocks the beta-5 chymotrypsin-like site of the 20S proteasome, causing misfolded-protein stress and apoptosis in myeloma cells. Taken once weekly, it allows an all-oral triplet with lenalidomide and dexamethasone for patients with multiple myeloma after at least one prior therapy. TOURMALINE-MM1 (2016) showed median progression-free survival of 20.6 versus 14.7 months when ixazomib was added to lenalidomide-dexamethasone in relapsed disease, and approval followed in the US in 2015 and the EU in 2016. The maintenance trials TOURMALINE-MM3 and MM4 showed modest progression-free survival gains. It causes less neuropathy than bortezomib but is less potent than carfilzomib, so it is often chosen for convenience or frailty rather than depth of response. For a newcomer, ixazomib is the proteasome inhibitor you can take at home.","status":"approved","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Ixazomib","links":[{"label":"Label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=ixazomib"}],"tags":["gap-fill"],"related":[],"cancers":["multiple-myeloma"],"sections":[],"technologies":["kinase-inhibitors"],"targets":[],"drugs":[],"companies":["takeda"],"institutions":[],"pathways":[],"terms":[],"trials":["nct04068597"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Ninlaro","modality":"Oral proteasome inhibitor (boronate)","mechanism":"Reversible inhibitor of the β5 chymotrypsin-like site of the 20S proteasome; weekly oral dosing.","approvals":[{"region":"US","year":2015,"indication":"Multiple myeloma after ≥1 prior therapy, with lenalidomide and dexamethasone"},{"region":"EU","year":2016,"indication":"Same"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/ixazomib/","neighbours":{"cancer":[{"id":"multiple-myeloma","kind":"cancer","name":"Multiple myeloma","route":"/cancers/multiple-myeloma/"}],"technology":[{"id":"kinase-inhibitors","kind":"technology","name":"Small-molecule kinase inhibitors","route":"/technologies/kinase-inhibitors/"}],"company":[{"id":"takeda","kind":"company","name":"Takeda","route":"/companies/takeda/"}],"trial":[{"id":"nct04068597","kind":"trial","name":"Study to Evaluate CCS1477 (Inobrodib) in Haematological Malignancies","route":"/trials/nct04068597/"}],"term":[{"id":"proteasome-inhibitor","kind":"term","name":"Proteasome inhibitor (bortezomib, carfilzomib, ixazomib)","route":"/terms/proteasome-inhibitor/"}],"pathway":[{"id":"ubiquitin-proteasome-system","kind":"pathway","name":"Ubiquitin-proteasome system & protein homeostasis","route":"/pathways/ubiquitin-proteasome-system/"}]}}