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葡萄牙多发性骨髓瘤的真实世界治疗模式、资源利用和费用负担。

Real-world treatment patterns, resource use and cost burden of multiple myeloma in Portugal.

机构信息

Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal.

Bristol-Myers Squibb, Rueil Malmaison, France.

出版信息

Eur J Cancer Care (Engl). 2019 Jul;28(4):e13026. doi: 10.1111/ecc.13026. Epub 2019 Mar 3.

Abstract

OBJECTIVE

We provide a real-world overview of multiple myeloma (MM) treatment patterns, outcomes and healthcare resource use (HRU) in Portugal.

METHODS

Data were collected retrospectively from consecutive patients diagnosed/treated at the Portuguese Oncology Institute of Porto (IPO-Porto) between 2012 and 2015. Primary objectives were progression-free survival (PFS) and overall survival (OS), with treatment patterns and HRU secondary. Analysis was by line of therapy (LOT), and post hoc by age (<65/≥65 years).

RESULTS

165, 73 and 32 patients received first, second and third LOTs respectively (N = 187). OS probabilities were 91.5%, 83.2% (<65 years) and 86.6%, 65.3% (≥65 years) at 12, 24 months respectively. PFS decreased from the start of each LOT for both age groups and was less for patients ≥65 years. Younger patients received more combination treatment (immunomodulatory drugs + proteasome inhibitors) and stem cell transplants, and had higher mean costs than older patients (€81,213 vs. €36,864 where three LOTs were received). Cost drivers were medications, transplantations and hospitalisations.

CONCLUSION

Our results suggest divergence between younger and older MM patients. Older patients had lower OS and PFS probabilities, HRU costs and fewer stem cell transplantations. The treatment patterns in each LOT may differ from other countries' findings, suggesting treatment heterogeneity.

摘要

目的

我们提供了葡萄牙多发性骨髓瘤(MM)治疗模式、结局和医疗资源使用(HRU)的真实世界概述。

方法

数据从 2012 年至 2015 年期间在葡萄牙波尔图肿瘤学研究所(IPO-Porto)连续诊断/治疗的患者中回顾性收集。主要目标是无进展生存期(PFS)和总生存期(OS),次要目标是治疗模式和 HRU。分析按治疗线(LOT)进行,事后按年龄(<65/≥65 岁)进行分析。

结果

165、73 和 32 名患者分别接受了一线、二线和三线治疗(N=187)。12、24 个月时,OS 概率分别为 91.5%、83.2%(<65 岁)和 86.6%、65.3%(≥65 岁)。两个年龄组的 PFS 均从每个 LOT 的开始时下降,且≥65 岁的患者下降更为明显。年轻患者接受了更多的联合治疗(免疫调节药物+蛋白酶体抑制剂)和干细胞移植,且比老年患者的平均费用更高(接受三线治疗的患者为€81,213 比€36,864)。成本驱动因素是药物、移植和住院治疗。

结论

我们的结果表明,年轻和老年 MM 患者之间存在差异。老年患者的 OS 和 PFS 概率、HRU 成本和干细胞移植较少。每个 LOT 的治疗模式可能与其他国家的发现不同,表明治疗存在异质性。

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