Real-world treatment patterns and outcomes of triple-class treated patients with multiple myeloma in the United States

• Published in: Expert review of hematology Vol. 16; no. 1; p. 65
• Main Authors: Varughese, Prateesh, Smith, Robert, Xue, Mei, Dorrow, Natalie, Hogea, Cosmina, Maiese, Eric M, Buckingham, Trudy
• Format: Journal Article
• Language: English
• Published: England 02-01-2023
• Subjects: Antineoplastic Combined Chemotherapy Protocols - adverse effects; Drug Resistance, Neoplasm; Humans; Multiple Myeloma - drug therapy; Multiple Myeloma - etiology; Prognosis; Proteasome Inhibitors - therapeutic use; Treatment Outcome; United States - epidemiology; United States; options; refractory; Exposure; survival; retreatment
• ISSN: 1747-4094
• DOI: 10.1080/17474086.2023.2154648

Although multiple myeloma (MM) survival has improved following the introduction of proteosome inhibitors, immunomodulatory drugs, and anti-CD38 therapies, patients become refractory to these agents. Real-world outcomes of triple-class exposed patients are limited and were investigated in this study.
The Integra Connect Database was used to assess the treatment patterns of triple-class exposed patients with relapsed/refractory MM (RRMM) (January 2016-December 2019).
During this period, patients (
= 501) reached triple exposure in a median of three lines of therapy (LOTs) over 995 days. A new LOT was started in a median of 18 (1-691) days after triple exposure; 71% of the patients started a new LOT within 30 days. Throughout the follow-up period, 8% of the patients had a therapy gap greater than 90 days. Following triple exposure, 103/501 patients (21%) received only triple-class agents in subsequent LOTs, while 24 (4.8%) patients received only non-triple-class agents. The median apparent survival from initiation of first therapy after triple exposure was 308 days.
These results indicate that recycling of triple-class agents after previous exposure is widespread and prognosis in the RRMM population remains poor, highlighting the continuing unmet need for new agents with novel mechanisms to improve patient outcomes.