Diagnosis and treatment of multiple myeloma in Germany: analysis of a nationwide multi-institutional survey

Abstract

A nationwide, multi-institutional survey was performed in 2011 and 2015 to analyze routine practice for myeloma patients outside clinical trials in Germany. We contacted university hospitals, community hospitals, and office-based hematologists in order to enter clinical data from newly diagnosed and relapsed patients into an online platform. Complete datasets were available for 478 (2011) and 515 (2015) patients. While median age at diagnosis increased from 70 to 72 years, patients had fewer concomitant diseases (2011 61%; 2015 51%) and presented with equal performance status (ECOG 0-1, 2011 66%; 2015 68%). Cytogenetic analysis was performed in 53% (2011) and 59% (2015). Patients ≥70 years, or patients with comorbidities who were no candidates for autologous transplantation (ASCT), were less frequently tested for cytogenetic abnormalities (p = 0.001, respectively). There were more candidates for ASCT ≥65 years in 2015 (57%) than in 2011 (27%). Bortezomib was used in 92% of transplant-eligible and 66% of transplant-ineligible patients as frontline therapy in 2015. Application of bortezomib and lenalidomide for the first relapse changed from 2011 (bortezomib 45%; lenalidomide 27%) to 2015 (bortezomib 28%; lenalidomide 54%). For the second relapse, application of lenalidomide decreased from 2011 (36%) to 2015 (23%). Pomalidomide entered treatment for the second relapse in 2015 (11% of patients). Taken together, we demonstrate that results from clinical trials are implemented into general practice in Germany.

Real-World Evaluation of Health-Related Quality of Life in Patients With Multiple Myeloma From Germany

“…Furthermore, the observed MM treatment patterns are similar to those reported in previous publications of real-world data from Germany. 36,37 These factors, along with the large sample size included, suggest that our HRQoL results should be generalizable to Germany as a whole. Moreover, the similarities between our data and those reported from France 34 and Spain 35 suggest that these results may be more widely generalizable across Europe.…”

Adjusted Comparison of Outcomes between Patients from CARTITUDE-1 versus Multiple Myeloma Patients with Prior Exposure to PI, Imid and Anti-CD-38 from a German Registry

“…In the current study, patient outcomes with cilta-cel, as observed in CARTITUDE-1, were compared with outcomes from similar patients treated with RWCP, as observed in Therapie Monitor in Germany. Therapie Monitor provides a representative sample of patients from German routine clinical practice and has excellent variable coverage, ensuring reliable comparisons [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. This is further illustrated by the observed median OS and TTNT in Therapie Monitor of 9.89 and 6.21 months, respectively, consistent with outcomes in other sources and geographies [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Budget impact analysis of the use of oral and intravenous therapy regimens for the treatment of relapsed or refractory multiple myeloma in Germany

“…The distribution of the prevalent target population among the considered therapy regimens was based on the results from a nationwide, multi-institutional survey on treatment of multiple myeloma patients in Germany (TherapyMonitor) [13]. Previous analyses revealed that the database from the TherapyMonitor has a good external validity to the German population regarding the distribution of treated patients with multiple myeloma [14].…”