The development of a home-based therapeutic platform for multiple myeloma

ABSTRACT

Background

Multiple Myeloma (MM) accounts for 1–2% of all malignancies but is the second most common hematological malignancy. It is characterized by a proliferation of malignant plasma cells. The treatment paradigm of MM in Australia is traditionally hospital-based, complex, and costly. While MM comprises 1–2% of cancer diagnoses, it appears in the top 10 cancer diagnoses requiring hospital admission. The cumulative time spent receiving treatment is a significant burden for patients. The ability to receive treatment at home and maximize time away from hospital-based settings is a key preference for patients receiving anticancer therapies over a prolonged period of time.

Methods

The Peter MacCallum Cancer Centre and Royal Melbourne Hospital’s combined Clinical Hematology Unit has collaborated with their Hospital in the Home departments to develop several innovative programs to address this.

Results

We describe our current active programs and potential developments in home-based MM therapy.

Conclusion

We have enabled large numbers of patients to receive complex therapies in their own home and the COVID-19 pandemic has increased the pace of the roll out without any compromise in safety. We anticipate that the next raft of immunotherapies will be able to transition into the @Home treatment setting in the coming years.

KEYWORDS:

• Multiple myeloma
• autologous stem cell transplant
• Bortezomib
• carfilzomib
• nurse-led
• home-based

Author contributions

H Beer, D Routledge and S Harrison were involved in analyzing, interpreting and writing up the outcomes of the three home-based therapy programs included in this manuscript. All other authors were involved with the development and implementation of these programs and contributed to the content of their relevant sections. All authors agree to be accountable for all aspects of the work

Declaration of interest

H Beer reports grant and advisory board funding from Bristol Myers Squibb, Janssen and Antengene.

D Routledge reports honoraria and speakers fees from Amgen, Janssen and Sandoz.

S Harrison reports honoraria, research funding, consultancy, investigator, and advisory board fees from AbbVie, Amgen, Celgene, GSK, Janssen Cilag, Novartis, Roche/Gentec, Takeda, Haemalogix, Sanofi, Eusa and Terumo.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Review disclosure

A Peer Review of this paper reports that they are a consultant for Takeda. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.