Hydren Jay R, Lin Dee, Sweeney Nathan W, Wu Bingcao, Kim Nina, Patel Saurabh, Sborov Douglas W, Berdeja Jesus G, Anderson Larry D, Huo Stephen, Hurtado Martínez Jorge Arturo, Ahlstrom Jennifer M
HealthTree Foundation, Lehi, UT, United States.
Janssen Scientific Affairs, LLC, Horsham, PA, United States.
Front Health Serv. 2024 Apr 24;4:1354760. doi: 10.3389/frhs.2024.1354760. eCollection 2024.
Advances in multiple myeloma (MM) treatment have shifted the therapeutic landscape. Understanding patients' perspectives can assist physicians in helping patients make informed decisions. This study aimed to understand the patient decision-making process and gain insights into patient perspectives on B-cell maturation antigen (BCMA)-targeted therapies for MM.
An 18-question survey was completed by patients with MM enrolled in HealthTree® Cure Hub, an online portal helping patients with plasma cell dyscrasias navigate their disease.
From October 28, 2022, to January 12, 2023, 325 patients with MM participated in the survey. The mean age (standard deviation) of the respondents was 66 (8) years; 54% were female and 90% were White. Among 218 patients with complete clinical records in the database, the median (min, max) lines of therapy (LOT) was 2 (1,16). Among 61 (28%) patients who had received ≥4 LOTs, 55 (90%) were triple-class exposed. Of the 290 patients who responded to the question about openness to new therapies, 76 (26%) were open to trying a new therapy immediately and 125 (43%) wanted more information on safety and efficacy. Most respondents reported likely or very likely to try a BCMA CAR T-cell therapy (60%) or a bispecific antibody (74%) and some needed more information to decide (16% for CAR T-cell therapy and 13% for bispecific antibody). The most requested information included efficacy, side effects (SEs), eligibility, and administration process for both CAR T-cell and bispecific therapies. When 2 therapies with the same efficacy and duration of response were offered, 69% of respondents would prefer the therapy with a lower risk of severe SEs but requires continuous dosing with no treatment-free interval, and 31% preferred a therapy given once followed by a treatment-free interval but with a potentially higher risk of severe SEs. To receive an effective therapy, the top acceptable trade-offs included frequent monitoring of SEs and initiating a new therapy in a hospital setting, and the least acceptable compromise was caregiver burden.
This study found a high level of openness in patients with MM to try BCMA-targeted therapies. Information on efficacy, safety, availability, and eligibility may assist patients on decision-making.
多发性骨髓瘤(MM)治疗的进展改变了治疗格局。了解患者的观点有助于医生帮助患者做出明智的决策。本研究旨在了解患者的决策过程,并深入了解患者对MM的B细胞成熟抗原(BCMA)靶向治疗的看法。
参与HealthTree® Cure Hub(一个帮助浆细胞发育异常患者应对疾病的在线平台)的MM患者完成了一项包含18个问题的调查。
2022年10月28日至2023年1月12日,325名MM患者参与了调查。受访者的平均年龄(标准差)为66(8)岁;54%为女性,90%为白人。在数据库中有完整临床记录的218名患者中,治疗线数(LOT)的中位数(最小值,最大值)为2(1,16)。在接受过≥4线治疗的61名(28%)患者中,55名(90%)接受过三类药物治疗。在回答关于对新疗法接受程度问题的290名患者中,76名(26%)愿意立即尝试新疗法,125名(43%)希望获得更多关于安全性和有效性的信息。大多数受访者表示可能或非常可能尝试BCMA嵌合抗原受体(CAR)T细胞疗法(60%)或双特异性抗体(74%);一些人需要更多信息来做决定(CAR T细胞疗法为16%,双特异性抗体为13%)。最需要的信息包括CAR T细胞疗法和双特异性疗法的疗效、副作用(SEs)、资格和给药过程。当提供两种疗效和反应持续时间相同的疗法时,69%的受访者会选择严重SEs风险较低但需要持续给药且无无治疗间隔的疗法,31%的受访者更喜欢一次给药后有无治疗间隔但严重SEs风险可能较高的疗法。为了接受有效的治疗,最可接受的权衡包括频繁监测SEs和在医院环境中开始新疗法;最不可接受的妥协是照顾者负担。
本研究发现MM患者对尝试BCMA靶向疗法的接受程度较高。关于疗效、安全性、可用性和资格方面的信息可能有助于患者做出决策。