Braunlin Megan, Belani Rajesh, Buchanan Jacqueline, Wheeling Travis, Kim Christopher
Amgen, Inc, Thousand Oaks, CA, USA.
Amgen Inc., South San Francisco, CA, USA.
Leuk Lymphoma. 2021 Feb;62(2):377-386. doi: 10.1080/10428194.2020.1827253. Epub 2020 Oct 7.
Multiple myeloma treatment has evolved with approvals of new immunomodulatory imide drugs (IMiDs), monoclonal antibodies (MoABs), and proteasome inhibitors (PIs). We characterized U.S. treatment trends and survival from 2011 to 2019 using Flatiron data from multiple myeloma patients followed from treatment index until death/end of data. Patients ( = 10,553) were primarily (88%) treated in community centers. Frontline PI-IMiD-dexamethasone use increased over time, while IMiD-dexamethasone and PI-dexamethasone use decreased. MoAB-IMiD-dexamethasone use increased in relapsed/refractory disease. In all lines, use of doublets decreased and triplets increased, with triplets becoming the most prescribed combination by 2018-2019, especially in first line (62%). Monotherapy use decreased in first line (19% to 10%) but remained steady in relapsed/refractory disease (∼20%). With each increasing line of therapy, median overall survival decreased (60, 48, 36, 29, 23 months). Survival increased with more recent diagnosis. Our results indicate that the multiple myeloma landscape has evolved significantly in the last decade.
随着新型免疫调节性酰亚胺药物（IMiDs）、单克隆抗体（MoABs）和蛋白酶体抑制剂（PIs）的获批，多发性骨髓瘤的治疗方法不断发展。我们利用Flatiron数据对2011年至2019年美国多发性骨髓瘤患者的治疗趋势和生存率进行了分析，这些数据涵盖了从治疗开始到死亡/数据结束的患者情况。患者（n = 10553）主要（88%）在社区中心接受治疗。一线使用蛋白酶体抑制剂-免疫调节性酰亚胺药物-地塞米松的情况随时间增加，而免疫调节性酰亚胺药物-地塞米松和蛋白酶体抑制剂-地塞米松的使用则减少。在复发/难治性疾病中，单克隆抗体-免疫调节性酰亚胺药物-地塞米松的使用增加。在所有治疗线中，双联疗法的使用减少，三联疗法的使用增加，到2018 - 2019年，三联疗法成为最常用的联合治疗方案，尤其是在一线治疗中（62%）。一线单药治疗的使用从19%降至10%，但在复发/难治性疾病中保持稳定（约20%）。随着治疗线数的增加，中位总生存期缩短（60、48、36、29、23个月）。生存率随着诊断时间的推移而提高。我们的结果表明，在过去十年中，多发性骨髓瘤的治疗格局发生了显著变化。
