Attrition Rates in Multiple Myeloma Treatment under Real World Conditions—An Analysis from the Austrian Myeloma Registry (AMR)

Abstract

Multiple myeloma (MM) is characterized by serial relapses, necessitating the application of sequential lines of therapy (LoT). Reports on attrition rates (ARs) vary widely. The present study analysed ARs from the Austrian Myeloma Registry. Attrition was defined as being either deceased, progressive without having received another LoT, or lack of follow-up for ≥5 years. A total of 571 patients diagnosed between January 2009 and August 2021 were included (median age: 72 years; median follow-up: 50.8 months). Some 507 patients received at least one LoT. Of the total, 43.6% underwent autologous stem cell transplantation (SCT, transplant eligible = TE)) with primarily VRd (Bortezomib/Lenalidomide/Dexamethasone) given as induction (26.5%), followed by lenalidomide maintenance in 55.7% of cases. Transplant-ineligible (NTE) patients were predominantly treated with Vd (Bortezomib/Dexamethasone, 21.6%), receiving maintenance in 27.1%. A total of 37.5% received a second LoT. ARs across one to five LoTs were 16.7–27%. Frontline induction/ SCT followed by maintenance reduced ARs associated with age and achievement of deep remission in the frontline. Deep remission prolongs follow-up and time-to-next-treatment (TTNT), while high-risk-cyctogenetics negatively affected these outcomes. Our results demonstrate considerably lower ARs for MM patients within the AMR data versus other healthcare systems. Young age and the achievement of significant remissions after optimal frontline therapy resulted in particularly low ARs. These promising results support a key role for the ease of drug access and reimbursement policies in governing long-term MM patient outcomes.

Mezigdomide—A Novel Cereblon E3 Ligase Modulator under Investigation in Relapsed/Refractory Multiple Myeloma

“…Over the past 40 years, multiple myeloma (MM) has evolved from an acute disease with a median overall survival (OS) of only ~3–4 years [ 1 ] to become a chronic disease in which the median OS is now 7–10 years [ 2 , 3 ], and patients can require multiple lines of therapy over their disease course [ 4 , 5 , 6 , 7 ]. In the context of a global annual incidence of approximately 180,000 new cases [ 8 ], including more than 35,000 in the United States alone [ 9 ], and the continuing increase in survival rates [ 10 ], there is a growing population of patients requiring additional treatment options.…”

Real-world assessment of treatment multiple myeloma patients on the example of one hematology center

“…Показатели отсева обычно измеряются и сообщаются в клинических исследованиях для оценки эффективности терапии. Более высокие показатели отсева свидетельствуют о том, что значительная часть пациентов по разным причинам не может пройти полный курс лечения, например, из-за прогрессии заболевания, побочных эффектов, нарушения комплаентности и других причин [10].…”