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

ABSTRACT

Objectives

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.

Methods

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).

Results

During this period, patients (N = 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.

Conclusion

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.

KEYWORDS:

• Exposure
• options
• refractory
• retreatment
• survival

Acknowledgments

Writing assistance was provided by Jiah Pearson-Leary, PhD and Elisabeth Walsby, PhD of Fishawack Indicia Ltd, part of Fishawack Health and funded by GSK.

This publication is dedicated to Dr Robert Smith, MD, who passed away shortly before submission, in honor of his contributions to oncology and dedication to his patients.

Author contributions

E Maiese, C Hogea, and T Buckingham contributed to study design and data analysis and interpretation. R Smith, N Dorrow, M Xue, and P Varughese contributed to study design, acquisition of data, analysis, and interpretation. All authors reviewed and approved the final version and agree to be accountable for all aspects of this work.

Declaration of interests

PV and MX are paid employees of Integra Connect LLC and have received research funding from GSK (Study 213286) paid to Integra Connect LLC. RS had nothing to disclose. ND was a paid employee of Integra Connect LLC at the time this analysis was completed and received research funding from GSK (Study 213286) paid to Integra Connect LLC. CH, EM, and TB were employees of GSK at the time of analysis. CH and TB hold stocks/shares in GSK.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17474086.2023.2154648

Additional information

Funding

This study was funded by GSK, Philadelphia, PA (Study 213286).