Recent real-world treatment patterns and outcomes in US patients with relapsed/refractory multiple myeloma

Expert Rev Hematol. 2020 Sep;13(9):1017-1025. doi: 10.1080/17474086.2020.1800451. Epub 2020 Aug 26.

Abstract

Background: In patients with relapsed/refractory multiple myeloma (RRMM) previously receiving 1-3 therapy lines, newer agents demonstrated improved outcomes versus older agents. Real-world treatment pattern data are limited. We assessed real-world treatment patterns and outcomes in patients with RRMM (≥2 prior therapy lines).

Research design and methods: An electronic medical record (EMR) analysis and chart review were conducted using International Oncology Network (ION) EMR data. Patients ≥18 years old initiating first-line MM treatment 1 January 2011, to 31 May 2017, were stratified into older/newer treatment cohorts (approval date before vs during/after 2012). Treatment patterns and outcomes were described; no statistical tests were performed.

Results: In the EMR analysis (n = 1601) and chart review (n = 456), bortezomib, lenalidomide, and bortezomib-lenalidomide combinations dominated first-line treatment. Median real-world progression-free survival (rwPFS) was 12.0 to 3.5 months (first- to fifth-line), and median real-world overall survival (rwOS) was 48.2 to 5.8 months. A trend for increased rwPFS/rwOS with newer versus older treatments was observed. Most common AEs were fatigue, bone pain, and anemia.

Expert opinion: Real-world data describing treatment patterns in relapsed/refractory multiple myeloma are limited. Evaluation of new treatments on patient outcomes will influence treatment patterns and patient outcomes in the real-world setting.

Conclusions: Although a trend for improved rwPFS and rwOS with newer versus older treatments was suggested, additional treatment options to improve patient outcomes are needed.

Keywords: Multiple myeloma; overall survival; progression-free survival; real-world; relapsed/refractory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / methods
  • Disease Management
  • Drug Resistance, Neoplasm
  • Duration of Therapy
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / epidemiology*
  • Multiple Myeloma / mortality
  • Multiple Myeloma / therapy
  • Outcome Assessment, Health Care
  • Practice Patterns, Physicians'*
  • Prognosis
  • Recurrence
  • Retreatment
  • Retrospective Studies
  • Time-to-Treatment
  • United States / epidemiology