Multiple Myeloma Treatment in Real-world Clinical Practice: Results of a Prospective, Multinational, Noninterventional Study

Mohty M, Terpos E, Mateos MV, Cavo M, Lejniece S, Beksac M, Bekadja MA, Legiec W, Dimopoulos M, Stankovic S, Soledad Duran M, De Stefano V, Corso A, Kochkareva Y, Laane E, Berthou C, Salwender H, Masliak Z, Peceliunas V, Willenbacher W, Silva J, Louw V, Nemet D, Borbenyi Z, Abadi U, Pedersen RS, Cernelc P, Potamianou A, Couturier C, Feys C, Thoret-Bauchet F, Boccadoro M (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Book Volume: 18

Pages Range: e401-e419

Journal Issue: 10

DOI: 10.1016/j.clml.2018.06.018

Abstract

Multiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits.

Involved external institutions

Medical University of Lublin / Uniwersytet Medyczny w Lublinie Poland (PL) Hôpital Saint-Antoine France (FR) National and Kapodistrian University of Athens Greece (GR) University Health Network (UHN) Canada (CA) Rīga Stradiņš University Latvia (LV) Ankara University / Ankara Üniversitesi Turkey (TR) Complejo Hospitalario de Jaén Spain (ES) Catholic University of the Sacred Heart / Università Cattolica del Sacro Cuore Italy (IT) Università degli Studi di Pavia Italy (IT) City Polyclinic No. 68 of the Moscow City Healthcare Department (Moscow State Healthcare Institution) Russian Federation (RU) North Estonia Medical Centre Estonia (EE) Asklepios Kliniken Germany (DE) Institute of Blood Pathology and Transfusion Medicine of the National Academy of Medical Sciences of Ukraine (IPKTM) / Інститут патології крові та трансфузійної медицини НАМН України Ukraine (UA) Vilnius University Hospital Santaros Klinikos / Vilniaus Universiteto ligoninė Santaros klinikos Lithuania (LT) Klinik der Medizinischen Universität Innsbruck Austria (AT) University of the Free State South Africa (ZA) Zagreb University Hospital Centre / Klinički bolnički centar Zagreb (KBC) Croatia (HR) Semmelweis University / Semmelweis Egyetem Hungary (HU) Meir Medical Center / מרכז רפואי מאיר Israel (IL) Regional Hospital Holstebro Denmark (DK) Janssen-Cilag France France (FR) Janssen Global Services, LLC United States (USA) (US) University of Salamanca / Universidad de Salamanca Spain (ES) University of Bologna / Università di Bologna Italy (IT) Ljubljana University Medical Centre (Ljubljana UMC) / Univerzitetni klinični center Ljubljana Slovenia (SI) Université de Bretagne Occidentale France (FR) University of Turin / Università degli Studi di Torino (UNITO) Italy (IT)

How to cite

APA:

Mohty, M., Terpos, E., Mateos, M.-V., Cavo, M., Lejniece, S., Beksac, M.,... Boccadoro, M. (2018). Multiple Myeloma Treatment in Real-world Clinical Practice: Results of a Prospective, Multinational, Noninterventional Study. Clinical Lymphoma, Myeloma and Leukemia, 18(10), e401-e419. https://doi.org/10.1016/j.clml.2018.06.018

MLA:

Mohty, Mohamad, et al. "Multiple Myeloma Treatment in Real-world Clinical Practice: Results of a Prospective, Multinational, Noninterventional Study." Clinical Lymphoma, Myeloma and Leukemia 18.10 (2018): e401-e419.

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