Background: In multiple myeloma (MM), improving our understanding of routine clinical practice and the effectiveness of agents outside of clinical trials is important. TOURMALINE-MM1 data resulted in approval of ixazomib for MM patients who have received ≥ 1 prior therapy., Patients and Methods: UVEA-IXA comprised a retrospective chart review in the early access program, and a prospective 1-year follow-up period. Eligible patients had had a biochemical and/or symptomatic relapse after 1-3 prior lines of therapy; no anti-MM therapy for > 3 cycles at the start of ixazomib therapy; and an Eastern Cooperative Oncology Group performance score of 0-2. Lenalidomide- or proteasome inhibitor (PI)-refractory patients were ineligible. Primary endpoints were response and progression-free survival (PFS)., Results: Of 357 enrolled patients, 309 were evaluable; most patients received ixazomib alongside lenalidomide (98%) and dexamethasone (97%); 61% had received 2-3 prior lines of therapy. Median PFS was 15.6 months (95% confidence interval [CI]: 12.0-20.6) in all evaluable patients, and 19.6 (95% CI: 12.1-27.0) and 13.9 (95% CI: 10.1-18.1) months in patients who received 1 and ≥ 2 prior lines of therapy, respectively. The overall response rate was 67% in all evaluable patients, and 72% and 63%, respectively, in patients who received 1 and ≥ 2 prior lines of therapy. Median overall survival was 35.5 months. The ixazomib safety profile was consistent with previous reports., Conclusion: This study supports ixazomib-based therapy as an effective and tolerable treatment in the real-world. Outcomes were favorable in patients with 1 or ≥ 2 prior lines of therapy who were not lenalidomide- or PI-refractory., Competing Interests: Disclosures HL received research funding from Amgen and Sanofi; received payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Celgene-BMS, Janssen-Cilag, Sanofi, Amgen, Takeda, and AbbVie; participated on a Data Safety Monitoring Board or Advisory Board for Celgene-BMS, Janssen-Cilag, Sanofi, Amgen, Takeda, and AbbVie. KR received grant funding to his institution from Janssen, Amgen, Takeda, GSK, and Celgene-BMS; received honoraria from Janssen, Adaptive Biotech, Amgen, Takeda, AbbVie, Oncopeptides, Celgene-BMS, Pfizer, and GSK; received support for attending meetings and/or travel from BMS, Amgen, and Takeda; participated on Advisory Boards for Janssen, Adaptive Biotech, Amgen, Takeda, AbbVie, Oncopeptides, Celgene-BMS, Pfizer, and GSK. M-VM received payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Janssen, Celgene, Takeda, Amgen, GSK, AbbVie, Pfizer, Regeneron, Roche, Sanofi, Oncopeptides, and Steamline; participated on a Data Safety Monitoring Board or Advisory Board for Janssen, Celgene, Sanofi, Takeda, GSK, Pfizer, Roche, and Steamline. ML received payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Sandoz, Janssen, Takeda, and Amgen; participated on a Data Safety Monitoring Board or Advisory Board for Novartis, Janssen, Takeda, and Amgen. AO and LS are employees of MediNeos, the contract-research organization which was involved by Takeda EUCAN for the design, conduction, and analysis of the study. N-BE is a Takeda employee and hold shares in Takeda. DMS was a Takeda employee and held stock in Takeda when the study was conducted and the manuscript was developed; received support for the present manuscript from Takeda. FG is a Takeda employee and hold shares and stock in Takeda; received support for the present manuscript from Takeda. ET received support for the present manuscript from Takeda; received grants or contracts from Amgen, GSK, Janssen, Sanofi, and Takeda; received payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Amgen, Astra Zeneca, BMS, GSK, Janssen, Menarini, Novartis, Pfizer, Sanofi, and Takeda; received support for attending meetings and/or travel from Amgen, EUSA Pharma, and Takeda; participated on a Data Safety Monitoring Board or Advisory Board for BMS, GSK, Janssen, Sanofi, and Takeda. RH received grants/contracts to his institution from Janssen, Amgen, Celgene, BMS, Novartis, and Takeda; received consulting fees from Janssen, Amgen, Celgene, AbbVie, BMS, Novartis, PharmaMar, and Takeda; received payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Janssen, Amgen, Celgene, BMS, PharmaMar, and Takeda; received support for attending meetings and/or travel from Amgen, Celgene, Takeda, Janssen; participated on a Data Safety Monitoring Board or Advisory Board for BMS, Takeda, Amgen, Oncopeptides, Sanofi, Janssen, GSK. BK and VG have nothing to disclose. Steering committee membership: KR, NB-E, ET., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)