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美国复发/难治性多发性骨髓瘤患者的近期真实世界治疗模式和结局。

Recent real-world treatment patterns and outcomes in US patients with relapsed/refractory multiple myeloma.

机构信息

Value Evidence and Outcomes, GlaxoSmithKline , Collegeville, PA, USA.

Real World Evidence Oncology, Bayer HealthCare Pharmaceuticals, Inc , Whippany, NJ, USA.

出版信息

Expert Rev Hematol. 2020 Sep;13(9):1017-1025. doi: 10.1080/17474086.2020.1800451. Epub 2020 Aug 26.

DOI:10.1080/17474086.2020.1800451
PMID:32844683
Abstract

BACKGROUND

In patients with relapsed/refractory multiple myeloma (RRMM) previously receiving 1-3 therapy lines, newer agents demonstrated improved outcomes versus older agents. Real-world treatment pattern data are limited. We assessed real-world treatment patterns and outcomes in patients with RRMM (≥2 prior therapy lines).

RESEARCH DESIGN AND METHODS

An electronic medical record (EMR) analysis and chart review were conducted using International Oncology Network (ION) EMR data. Patients ≥18 years old initiating first-line MM treatment 1 January 2011, to 31 May 2017, were stratified into older/newer treatment cohorts (approval date before vs during/after 2012). Treatment patterns and outcomes were described; no statistical tests were performed.

RESULTS

In the EMR analysis (n = 1601) and chart review (n = 456), bortezomib, lenalidomide, and bortezomib-lenalidomide combinations dominated first-line treatment. Median real-world progression-free survival (rwPFS) was 12.0 to 3.5 months (first- to fifth-line), and median real-world overall survival (rwOS) was 48.2 to 5.8 months. A trend for increased rwPFS/rwOS with newer versus older treatments was observed. Most common AEs were fatigue, bone pain, and anemia.

EXPERT OPINION

Real-world data describing treatment patterns in relapsed/refractory multiple myeloma are limited. Evaluation of new treatments on patient outcomes will influence treatment patterns and patient outcomes in the real-world setting.

CONCLUSIONS

Although a trend for improved rwPFS and rwOS with newer versus older treatments was suggested, additional treatment options to improve patient outcomes are needed.

摘要

背景

在先前接受过 1-3 线治疗的复发/难治性多发性骨髓瘤(RRMM)患者中,新型药物与旧型药物相比,结果有所改善。但实际治疗模式的数据有限。我们评估了 RRMM(≥2 线既往治疗)患者的实际治疗模式和结局。

研究设计与方法

采用国际肿瘤网络(ION)电子病历(EMR)数据进行 EMR 分析和病历回顾。纳入 2011 年 1 月 1 日至 2017 年 5 月 31 日首次接受 MM 一线治疗且年龄≥18 岁的患者,根据药物批准时间(2012 年之前/期间/之后)分为旧型/新型治疗队列。描述治疗模式和结局,未进行统计学检验。

结果

在 EMR 分析(n=1601)和病历回顾(n=456)中,硼替佐米、来那度胺和硼替佐米-来那度胺联合方案在一线治疗中占主导地位。真实世界无进展生存期(rwPFS)中位数为 12.0-3.5 个月(一线至五线),真实世界总生存期(rwOS)中位数为 48.2-5.8 个月。观察到新型药物较旧型药物治疗 rwPFS/rwOS 趋势改善。最常见的不良反应为疲劳、骨痛和贫血。

专家意见

描述复发/难治性多发性骨髓瘤实际治疗模式的真实世界数据有限。新疗法对患者结局的评估将影响实际环境中的治疗模式和患者结局。

结论

尽管新型药物较旧型药物治疗显示出 rwPFS 和 rwOS 改善的趋势,但仍需要更多的治疗选择来改善患者结局。

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