Takeda Pharmaceutical Company Limited,  a global, R&D-driven pharmaceutical company, has submitted a New Drug Application (NDA) to the Ministry of Health, Labour and Welfare in Japan for ixazomib, the first oral proteasome inhibitor for the treatment of relapsed or refractory multiple myeloma.

The NDA was filed based on the results of TOURMALINE-MM1, a global phase 3 trial published in the New England Journal of Medicine in April. The trial demonstrated that the all-oral triplet regimen containing ixazomib, lenalidomide and dexamethasone significantly extended the progression-free survival (PFS) in patients with relapsed or refractory multiple myeloma, with a manageable safety profile and the convenience and practicality of oral dosing.

“Multiple myeloma remains a devastating, relapsing and incurable rare cancer. We designed our extensive global ohase 3 clinical trial program, which includes TOURMALINE-MM1, to address the unmet need for an effective, tolerable and conveniently dosed therapy that may reduce some of the burdens that patients currently face,” said Andrew Plump, M.D., Ph.D., Takeda chief medical and scientific officer. “Should it be approved, the NDA submission of ixazomib will enable the first all-oral, proteasome inhibitor-containing triplet regimen in Japan. We thank the patients and investigators who have contributed to the development of ixazomib and look forward to the opportunity of offering this innovative drug to patients in Japan.”

Multiple myeloma is a cancer of the plasma cells, which are found in the bone marrow. In multiple myeloma, a group of monoclonal plasma cells, or myeloma cells, becomes cancerous and multiplies. These malignant plasma cells have the potential to affect many bones in the body, possibly resulting in compression fractures, lytic bone lesions and related pain. Multiple myeloma can cause a number of serious health problems affecting the bones, immune system, kidneys and red blood cell count, with some of the more common symptoms including bone pain and fatigue, a symptom of anemia. Multiple myeloma is a rare form of cancer, with 114,000 new cases globally per year. It is reported that there are approximately 14,000 patients with multiple myeloma in Japan.

Ixazomib is a novel oral proteasome inhibitor which is being studied in multiple myeloma and systemic light-chain (AL) amyloidosis. Ixazomib was granted orphan drug designation for the treatment of patients with relapsed or refractory multiple myeloma by the Ministry of Health, Labour and Welfare in February, 2016. In the United States, an NDA was submitted based on the data of TOURMALINE-MM1 trial in July, 2015 and the US Food and Drug Administration (FDA) approval was obtained as a drug for treatment of patients with multiple myeloma who have received at least one prior therapy in November, 2015, four months prior to its Priority Review PDUFA date. Ixazomib then became available in the US in December, 2015 under the trade name “Ninlaro”.

The comprehensive ixazomib clinical development program, TOURMALINE, further reinforces Takeda’s ongoing commitment to developing innovative therapies for people living with multiple myeloma worldwide and the healthcare professionals who treat them.

TOURMALINE includes a total of five ongoing pivotal trials - four investigating every major multiple myeloma patient population and one in light-chain amyloidosis:  TOURMALINE-MM1: investigating ixazomib vs. placebo, in combination with lenalidomide and dexamethasone in relapsed and/or refractory multiple myeloma; TOURMALINE-MM2: investigating ixazomib vs. placebo, in combination with lenalidomide and dexamethasone in patients with newly diagnosed multiple myelom;  TOURMALINE-MM3: investigating ixazomib vs. placebo as maintenance therapy in patients with newly diagnosed multiple myeloma following induction therapy and autologous stem cell transplant (ASCT); TOURMALINE-MM4: investigating ixazomib vs. placebo as maintenance therapy in patients with newly diagnosed multiple myeloma who have not undergone ASCT;  TOURMALINE-AL1: investigating ixazomib plus dexamethasone vs. physician choice of selected regimens in patients with relapsed or refractory AL amyloidosis

In addition to the TOURMALINE programme, a large number of investigator initiated studies are evaluating ixazomib for patients globally.