Ixazomib
Ixazomib (Ninlaro) is the first oral proteasome inhibitor for multiple myeloma, enabling an all-oral triplet with lenalidomide and dexamethasone.
TOURMALINE-MM1 (2016): PFS 20.6 vs 14.7 months when added to lenalidomide-dexamethasone in relapsed myeloma; approved 2015. Maintenance trials (MM3/MM4) showed modest PFS gains; less neuropathy than bortezomib but less potent than carfilzomib.
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026).
- Commercial insurance
- covered with prior authorisation
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy.
- Assistance programmes
- Takeda Oncology Here2Assist
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
- Leukemia & Lymphoma Society financial support
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Appraised for
- With lenalidomide and dexamethasone for myeloma after 2 or 3 lines
- Notes
- Reappraised in TA870 (2023) and recommended for routine commissioning.
- Cancer Drugs Fund
- Entered the Cancer Drugs Fund under a managed access agreement; check the current CDF list for whether it has since moved to routine commissioning.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE TA505 · NHS England Cancer Drugs Fund list · SMC advice: ixazomib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2015 | Multiple myeloma after ≥1 prior therapy, with lenalidomide and dexamethasone |
| EU | 2016 | Same |
Trials
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Latest papers
topQuery for this drug: (TITLE:"Ixazomib" OR ABSTRACT:"Ixazomib" OR TITLE:"Ninlaro" OR ABSTRACT:"Ninlaro") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Ixazomib, not a curated reading list.
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