Raab Marc S, Cavo Michele, Delforge Michel, Driessen Christoph, Fink Leah, Flinois Alain, Gonzalez-McQuire Sebastian, Safaei Reza, Karlin Lionel, Mateos Maria-Victoria, Schoen Paul, Yong Kwee
Department of Internal Medicine, University of Heidelberg, Heidelberg, Germany.
"Seràgnoli" Institute of Haematology and Medical Oncology, Bologna University School of Medicine, Bologna, Italy.
Br J Haematol. 2016 Oct;175(1):66-76. doi: 10.1111/bjh.14193. Epub 2016 Jun 13.
Real-world data describing management of patients with multiple myeloma are limited. A European (Belgium, France, Germany, Italy, Spain, Switzerland, UK) observational chart review was conducted to address this. Physicians completed questionnaires for every patient seen during a 2-4-week observation period, regardless of treatment status. A total of 435 physicians completed 7635 cross-sectional chart reviews. Overall, 47% of patients were undergoing anti-tumour drug treatment, 42% had previously received ≥1 line of treatment and 12% had never received anti-tumour drug treatment. Of the patients treated by oncologists, onco-haematologists or internists, 95% received, or were expected to receive, at least one line of anti-tumour drug treatment, 61% received ≥2 lines of therapy and 38% received ≥3 lines. Except in the UK, the most commonly used induction therapies contained bortezomib (48%); lenalidomide was the most commonly used first-line maintenance therapy (45%) and second- and third-line agent overall (60% and 52% of patients at those lines, respectively). Bortezomib retreatment was used in 47% of patients who received it first line. Treatment patterns became more diverse with subsequent treatment lines. This study provides insight into real-world treatment patterns in Europe. While treatment practices are broadly similar across countries, some notable differences in the agents used exist.
关于多发性骨髓瘤患者管理的真实世界数据有限。为此开展了一项欧洲（比利时、法国、德国、意大利、西班牙、瑞士、英国）观察性图表审查。医生针对在2至4周观察期内诊治的每位患者填写问卷，无论其治疗状态如何。共有435名医生完成了7635份横断面图表审查。总体而言，47%的患者正在接受抗肿瘤药物治疗，42%的患者此前接受过≥1线治疗，12%的患者从未接受过抗肿瘤药物治疗。在由肿瘤学家、肿瘤血液学家或内科医生治疗的患者中，95%接受或预计接受至少1线抗肿瘤药物治疗，61%接受≥2线治疗，38%接受≥3线治疗。除英国外，最常用的诱导治疗方案包含硼替佐米（48%）；来那度胺是最常用的一线维持治疗药物（45%），也是总体二线和三线治疗的最常用药物（二线和三线治疗的患者分别占60%和52%）。47%接受过硼替佐米一线治疗的患者接受了硼替佐米再治疗。随着后续治疗线数的增加，治疗模式变得更加多样化。本研究深入了解了欧洲的真实世界治疗模式。虽然各国的治疗实践大致相似，但在使用的药物方面存在一些显著差异。
