Multiple Myeloma Treatment Transformed: A Population-Based Study of Changes in Initial Management Approaches in the United States

Abstract

Initial treatment for multiple myeloma has changed markedly. Most patients now receive novel agents, with a decline in the use of traditional chemotherapy. Use of transplantation and novel agents varies with race and insurance. These findings document rapid changes in patterns of care and highlight addressable disparities in myeloma care.

Receipt of Chemotherapy Among Medicare Patients With Cancer by Type of Supplemental Insurance

“…Prior studies have demonstrated that Medicaid recipients of all ages are less likely to obtain recommended care compared with those who are privately insured. [5][6][7] Medicare patients who do not have Medicaid or supplemental private insurance face significant out-of-pocket expenses. Medicare patients with no supplemental insurance have been reported to receive less cancer treatment.…”

Risk Stratification, Treatment Selection, and Transplant Eligibility in Multiple Myeloma: A Qualitative Study of the Perspectives and Self-Reported Practices of Oncologists

“…Interviewees cited a wide range of risk stratification strategies, although academic physicians identified cytogenetic testing as the most valuable risk assessment tool, followed by the formal International Myeloma Working Group or nccn risk stratification criteria 22 . Only 1 community physician reported using risk stratification in his practice-indeed, the predominant approach to determining transplantation referral and induction therapy for newly diagnosed patients in the community was informal.…”

“…Notably, new guidelines from the International Myeloma Working Group and the U.S. National Comprehensive Cancer Network (nccn) recommend the use of risk assessment and risk-adapted treatment of mm 14,15,[18][19][20] . However, population-and practice-level data about initial mm treatment patterns point to considerable variability in practice 21,22 . The underlying drivers of that variation remain poorly understood.…”

Blocking MET receptor signaling in multiple myeloma cells in vitro and in vivo

“…Over the past decade, new therapeutic agents have been incorporated into the treatment algorithm for patients with MM, increasing their survival rates. [1][2][3] Further research into new treatments for MM is essential in order to improve the survival of patients. One potential target for MM therapy is the hepatocyte growth factor (HGF)/mesenchymal-epithelial transition (MET) axis.…”