Oncology Medical Affairs, Pfizer Japan Inc., Tokyo, Japan.
Access & Value, Pfizer Japan Inc., Tokyo, Japan.
PLoS One. 2024 Sep 30;19(9):e0310333. doi: 10.1371/journal.pone.0310333. eCollection 2024.
Treatment trends for newly diagnosed multiple myeloma (NDMM) are not fully evaluated in real-world settings in the Japanese population. Triple-class exposed (TCE) patients with relapsed or refractory MM have a poor prognosis and limited treatment options. To clarify characteristics, treatment trends, and TCE status in Japanese patients with MM, we conducted a retrospective, non-interventional study. Data from patients with MM were extracted from a Japanese claims database between 2015 and 2022: this study identified patients with NDMM prescribed daratumumab (D), lenalidomide (R), and/or bortezomib (V) as 1st-line treatment. The patient characteristics and treatment trends were analyzed for non-transplant and transplant groups. Of 1,784 patients, non-transplant patients (n = 1,656, median age 75 years [range: 37-94]) received R+dexamethasone (Rd) (24.7%), Vd (23.8%), and RVd (15.6%) and transplant patients (n = 128, median age 61 years [range: 35-73]) received RVd (49.5%), Vd (18.7%), and DVd (8.4%) in 1st line. In the non-transplant group, the commonly prescribed treatment regimens were Rd for patients aged ≥75 years, Vd for patients aged 65-74 years, and RVd for patients aged <65 years. Patients with renal or cardiac dysfunction commonly received Vd or Rd, respectively. In the transplant group, 107 (83.6%) and 20 (15.6%) patients received transplantation in the 1st and 2nd lines, respectively. The top three regimens as induction therapy before stem cell transplantation were RVd (49.5%), Vd (18.7%), or DVd (8.4%) in 1st line. Cumulative TCE patients by 5th line were 351 (21.2%) and 56 (43.8%) for non-transplant and transplant patients, respectively. TCE ratio at each line gradually increased from 1st to 5th line (11.1-69.2% in the non-transplant group and 21.1-100% in the transplant group, respectively). Of 184 TCE patients in the non-transplant group, 89.7% received sequencing treatments including DRd, RVd, and DVd, and 10.3% received D-RVd in 1st line.
在日本人群中，新诊断多发性骨髓瘤（NDMM）的治疗趋势并未在真实环境中得到充分评估。复发或难治性 MM 的三药暴露（TCE）患者预后较差，治疗选择有限。为了阐明日本 MM 患者的特征、治疗趋势和 TCE 状况，我们进行了一项回顾性、非干预性研究。从 2015 年至 2022 年，从日本索赔数据库中提取了 MM 患者的数据：本研究确定了接受达雷妥尤单抗（D）、来那度胺（R）和/或硼替佐米（V）作为一线治疗的 NDMM 患者。对非移植和移植组的患者特征和治疗趋势进行了分析。在 1784 名患者中，非移植患者（n = 1656，中位年龄 75 岁[范围：37-94]）接受了 Rd（24.7%）、Vd（23.8%）和 RVd（15.6%），移植患者（n = 128，中位年龄 61 岁[范围：35-73]）接受了 RVd（49.5%）、Vd（18.7%）和 DVd（8.4%）。在非移植组中，年龄≥75 岁的患者通常接受 Rd，年龄 65-74 岁的患者接受 Vd，年龄<65 岁的患者接受 RVd。肾功能或心功能不全的患者通常分别接受 Vd 或 Rd。在移植组中，107（83.6%）和 20（15.6%）名患者分别在一线和二线接受了移植。在干细胞移植前的诱导治疗中，前三种方案分别为 RVd（49.5%）、Vd（18.7%）或 DVd（8.4%）。非移植和移植患者的第 5 线累积 TCE 患者分别为 351（21.2%）和 56（43.8%）。从第 1 线到第 5 线，TCE 比例逐渐增加（非移植组为 11.1%-69.2%，移植组为 21.1%-100%）。在非移植组的 184 例 TCE 患者中，89.7%接受了包括 DRd、RVd 和 DVd 在内的序贯治疗，10.3%在一线接受了 D-RVd。
