Real-World Treatment Patterns, Outcomes in Patients With Double- and Triple-Class R/R Multiple Myeloma

Outcomes remain poor among patients with relapsed/refractory (R/R) multiple myeloma resistant to multiple drug classes, according to study results from a real-world patient population published in Leukemia & Lymphoma.

“The unmet needs of this group of patients remain high, substantiating the need for new therapies and effective combinations of therapies,” wrote lead author Peter Feng Wang, PhD, of GSK in Upper Providence, Pennsylvania, and coauthors.

Researchers used US electronic health records to assess treatment patterns and outcomes in adult patients with R/R multiple myeloma. The study included 650 patients with 3 or more prior lines of therapy that included a proteasome inhibitor (PI) and an immunomodulatory agent who were categorized as double-exposed. Patients were further categorized as double-class refractory (381 patients) if they were refractory to a PI and an immunomodulatory agent or triple-class refractory (173 patients) if refractory to a PI, immunomodulatory agent, and an anti-CD38 monoclonal antibody.

Survival outcomes among patients were poor, according to the study. Median overall survival was 22.3 months from the index line of therapy for double-class refractory patients and 11.6 months from the index line of therapy for triple-class refractory patients.

Triple-class refractory patients had shorter median duration of therapy and time to next treatment compared with double-class refractory patients, the study found. Higher baseline Eastern Cooperative Oncology Group performance scores and high-risk cytogenetic abnormalities were linked with poor outcomes in both double- and triple-class refractory patients.

“Findings from this study showed that patients with heavily pretreated R/R multiple myeloma in the United States were treated with a wide range of therapies, indicating that there was no typical treatment for this population,” researchers reported. “Moreover, the majority of patients discontinued their index line of therapy, mainly due to disease progression. Retreatment rates with PIs, an immunomodulatory agent, or anti-CD38 monoclonal antibody were high, even after patients had previously become refractory to these therapies.”

Reference:
Wang PF, Yee CW, Gorsh B, et al. Treatment patterns and overall survival of patients with double-class and triple-class refractory multiple myeloma: a US electronic health record database study. Leuk Lymphoma. Published online November 21, 2022. doi:10.1080/10428194.2022.2140284