About the NRd*Regimen
* NINLARO (ixazomib), REVLIMID (lenalidomide) and dexamethasone
What is the NRd regimen?
The NRd regimen is a combination of three drugs, Ninlaro, Revlimid and dexamethasone, that work together to kill myeloma cells. It is used in people who have received at least one previous myeloma treatment. On this website this combination will be referred to as 'NRd'.
The active ingredient in Ninlaro is ixazomib and the active ingredient in Revlimid is lenalidomide. You may hear these treatments called by either their brand name or the active ingredient. On this website, you'll see them referred to as Ninlaro and Revlimid.
Why have I been prescribed NRd?
Your doctor has prescribed NRd because he or she believes it can have a positive impact on your disease. Treatment for myeloma aims to kill myeloma cells and reduce the symptoms of disease.
In a clinical trial of 722 patients, those who received NRd had a 6 month longer median progression‑free survival than patients who received Revlimid and dexamethasone alone. This means that NRd increased the length of time before the myeloma started to come back by an average of 6 months, compared with Revlimid and dexamethasone alone.
How does each medicine work?
NRd contains three different treatments ( Ninlaro, Revlimid and dexamethasone) that work together to kill myeloma cells.
Ninlaro works by stopping proteasomes in the myeloma cell from working. Proteasomes digest proteins in cells and are important for cell survival. Because myeloma cells produce a lot of proteins, if the proteins cannot be digested, they build up in the cell and cause the myeloma cell to die.
Revlimid works in a number of different ways to affect the body's immune system and attack the cancer, by:
- Stopping the cancer cells developing
- Preventing blood vessels from growing within the cancer
- Boosting part of the immune system to attack the cancer cells
Dexamethasone is a steroid that can be used to reduce inflammation and is effective at killing myeloma cells when used in high doses. It can also help relieve sickness caused by chemotherapy.
How does Ninlaro (ixazomib) work?
Understanding proteasome inhibitors
The proteasomes in cells act like waste disposal units. The proteasomes digest unfolded or damaged proteins.
Myeloma cells undergo uncontrolled cell division. Ninlaro blocks the proteasomes in cells, causing a buildup of unfolded proteins.
Myeloma Cell Death
The buildup of unfolded proteins can lead to death of cancer cells.
Takeda Oncology has developed a practical guide for patients who have been prescribed NRd. It explains how NRd works, how to take it and possible side effects you may experience