Treatment patterns and overall survival of patients with double-class and triple-class refractory multiple myeloma: a US electronic health record database study

Figures & data

Table 1. Patient demographics and disease characteristics.

Characteristic		Double-exposed to PI and immunomodulatory agents N = 650	Double-class refractory to PI and immunomodulatory agents n = 381	Triple-class refractory to PI, immunomodulatory agents, and anti-CD38 mAb n = 173
Index dates	Median	Q2 2015	Q4 2015	Q2 2017
LOT prior to index LOT	Median	3	3	6
Age at index date, years	Median (IQR)	65.2 (57.2, 72.8)	65.0 (57.6, 72.8)	65.5 (59.9, 73.7)
Sex, n (%)	Male	348 (53.5)	213 (55.9)	86 (49.7)
Time from initial MM diagnosis to index, months	Median (IQR)	36.4 (23.2, 57.2)	40.8 (25.5, 66.0)	61.6 (40.1, 86.1)
Follow-up time, months	Median (IQR)	24.0 (10.5, 42.2)	14.3 (5.3, 29.2)	8.1 (3.3, 14.9)
Previous SCT, n (%)	Autologous SCT	402 (61.8)	237 (62.2)	120 (69.4)
	Allogeneic SCT	23 (3.5)	16 (4.2)	12 (6.9)
ISS disease stage, n (%)	Stage I	114 (17.5)	78 (20.5)	50 (28.9)
	Stage II	87 (13.4)	59 (15.5)	35 (20.2)
	Stage III	68 (10.5)	53 (13.9)	27 (15.6)
	Unknown	381 (58.6)	191 (50.1)	61 (35.3)
Cytogenetic abnormalities, n (%)	Standard-risk cytogenetics	233 (35.8)	145 (38.1)	65 (37.6)
	High-risk cytogenetics	314 (48.3)	212 (55.6)	114 (65.9)
Performance score, ECOG	Median (IQR)	1.0 (0.0, 1.0)	1.0 (1.0, 1.0)	1.0 (1.0, 1.0)
LDH, µL/mL	Median (IQR)	200.0 (170.0, 280.0)	200.0 (170.0, 272.5)	205.0 (170.0, 257.0)

CD38: cluster of differentiation-38; ECOG: Eastern Cooperative Oncology Group; IQR: interquartile range; ISS: International Staging System; LDH: lactate dehydrogenase; LOT: lines of therapy; mAb: monoclonal antibody; MM: multiple myeloma; PI: proteasome inhibitor; SCT: stem cell transplant.

Figure 1. Therapies received by double-exposed, double-class refractory and triple-class refractory patients in (A) baseline period (pre index LOT) and (B) during the index LOT. LOT: line of therapy.

Table 2. Reasons for discontinuation of index LOT.

Reasons for treatment discontinuation	Double-exposed to PI and immunomodulatory agents N = 650	Double-class refractory to PI and immunomodulatory agents n = 381	Triple-class refractory to PI, immunomodulatory agents, and anti-CD38 mAb n = 173
Discontinued, n (%)
Reason, n (%)	483 (74.3)	296 (77.7)	125 (72.3)
Progression	290 (60.0)	176 (59.5)	75 (60.0)
Toxicity	137 (28.4)	68 (23.0)	31 (24.8)
Doctor preference	64 (13.3)	42 (14.2)	13 (10.4)
Inadequate response	32 (6.6)	16 (5.4)	5 (4.0)
Patient preference	16 (3.3)	8 (2.7)	2 (1.6)
Death	11 (2.3)	18 (6.1)	11 (8.8)
Unknown	10 (2.1)	10 (3.4)	3 (2.4)
Insurance reason	1 (0.2)	1 (0.3)	1 (0.8)

CD38: cluster of differentiation-38; LOT: line of therapy; mAb: monoclonal antibody; PI: proteasome inhibitor.

Figure 2. Treatment patterns in double-exposed, double-class refractory and triple-class refractory patients. Levels of overall retreatment (use in more than one line of therapy) and retreatment once refractory to drug in (A) double-exposed, (B) double-class refractory, and (C) triple-class refractory patients. CD38: cluster of differentiation-38; mAb: monoclonal antibody; PI: proteasome inhibitor.

Figure 3. Kaplan–Meier curves showing the overall survival, duration of therapy and time to next treatment for the double-exposed, double-class refractory, and triple-class refractory groups of patients. CL: confidence limits; DR: double-class refractory; D-Exp: double-exposed; TR: triple-class refractory.

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