# Ixazomib

Source: https://onco.cc/drugs/ixazomib/  
OnCo record `ixazomib` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-08
- Tags: gap-fill
- Brand: Ninlaro
- Modality: Oral proteasome inhibitor (boronate)
- Mechanism: Reversible inhibitor of the β5 chymotrypsin-like site of the 20S proteasome; weekly oral dosing.
- Approvals: US 2015: Multiple myeloma after ≥1 prior therapy, with lenalidomide and dexamethasone; EU 2016: Same

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Ixazomib
- Label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=ixazomib

## Connected records

- cancers: [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/)
- technologies: [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/)
- companies: [Takeda](https://onco.cc/companies/takeda/)
- trials: [Study to Evaluate CCS1477 (Inobrodib) in Haematological Malignancies](https://onco.cc/trials/nct04068597/)
- terms: [Proteasome inhibitor (bortezomib, carfilzomib, ixazomib)](https://onco.cc/terms/proteasome-inhibitor/)
- pathways: [Ubiquitin-proteasome system & protein homeostasis](https://onco.cc/pathways/ubiquitin-proteasome-system/)

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