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在英国接受二线治疗的多发性骨髓瘤患者的真实世界特征和结局

Real-world characteristics and outcomes of patients with multiple myeloma receiving second-line treatment in England.

作者信息

Moore Sally, Cornic Laura, Crossman-Barnes Christina-Jane, Jose Sophie, Khalaf Zeyad, Yong Kwee, Soutar Megan, Woods Philip

机构信息

Department of Haematology University Hospitals Bristol and Weston NHS Foundation Trust Bristol UK.

GSK London UK.

出版信息

EJHaem. 2024 Dec 5;6(1):e1058. doi: 10.1002/jha2.1058. eCollection 2025 Feb.

Abstract

INTRODUCTION

Despite recent advances in first-line therapies for multiple myeloma (MM), most patients relapse or become refractory, underscoring the need for effective second-line (2L) regimens for relapsed/refractory MM (RRMM).

METHODS

This study describes the real-world baseline characteristics, treatment patterns and clinical outcomes of adult patients diagnosed with MM between 2013 and 2020 using data collated by the National Cancer Registration and Analysis Service (NCRAS) of the National Health Service in England. The study cohorts were broadly aligned to the eligibility criteria of the ongoing DREAMM-7 (D7) and DREAMM-8 (D8) clinical trials. We focus on lenalidomide-exposed/refractory patients who received daratumumab-bortezomib-dexamethasone (DaraVd) at 2L in both cohorts.

RESULTS

In the D7-like cohort, the lenalidomide-exposed (= 282) and lenalidomide-refractory (= 143) patients who received DaraVd at 2L had a median (95% confidence interval [CI]) time to next treatment or death (TTNTD) of 15.1 (12.6-22.4) and 10.3 (7.4-13.9) months, respectively. In the D8-like cohort, the lenalidomide-exposed (= 269) and lenalidomide-refractory (= 148) patients who received DaraVd at 2L had a median (95% CI) TTNTD of 14.5 (11.7-19.7) and 10.0 (7.3-13.7) months, respectively.

CONCLUSION

Patients with RRMM in England receiving DaraVd at 2L have poor clinical outcomes, highlighting the urgent need for new therapies, particularly for lenalidomide-refractory patients.

摘要

引言

尽管多发性骨髓瘤(MM)一线治疗近期取得了进展,但大多数患者会复发或变得难治,这凸显了针对复发/难治性MM(RRMM)有效二线(2L)方案的必要性。

方法

本研究利用英国国家医疗服务体系的国家癌症登记与分析服务(NCRAS)整理的数据,描述了2013年至2020年间诊断为MM的成年患者的真实世界基线特征、治疗模式和临床结局。研究队列大致符合正在进行的DREAMM-7(D7)和DREAMM-8(D8)临床试验的纳入标准。我们重点关注在两个队列中接受2L达雷妥尤单抗-硼替佐米-地塞米松(DaraVd)治疗的接受过来那度胺治疗/难治的患者。

结果

在类似D7的队列中,接受2L DaraVd治疗的接受过来那度胺治疗(=282例)和来那度胺难治(=143例)的患者下次治疗或死亡的中位(95%置信区间[CI])时间分别为15.1(12.6-22.4)个月和10.3(7.4-13.9)个月。在类似D8的队列中,接受2L DaraVd治疗的接受过来那度胺治疗(=269例)和来那度胺难治(=148例)的患者下次治疗或死亡的中位(95%CI)时间分别为14.5(11.7-19.7)个月和10.0(7.3-13.7)个月。

结论

在英国接受2L DaraVd治疗的RRMM患者临床结局较差,凸显了对新疗法的迫切需求。特别是对于来那度胺难治患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d3b/11756965/f1a60cd29512/JHA2-6-e1058-g002.jpg

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