CHARACTERISTICS AND TREATMENT OUTCOMES OF NEWLY DIAGNOSED MULTIPLE MYELOMA (NDMM) NON-STEM CELL TRANSPLANT (NSCT) PATIENTS IN THE UK, GERMANY, AND FRANCE
Author(s): ,
Wolfgang Knauf
Affiliations:
Center for Hematology and Oncology,Agaplesion Bethanien Hospital,Frankfurt am Main,Germany
,
Dorothy Romanus
Affiliations:
Millennium Pharmaceuticals,Cambridge,United States
,
M. Janelle Cambron-Mellott
Affiliations:
Kantar Health,New York,United States
,
Haris G. Vikis
Affiliations:
Kantar Health,New York,United States
,
Dasha Cherepanov
Affiliations:
Millennium Pharmaceuticals,Cambridge,United States
,
Katharina Verleger
Affiliations:
Pharmerit International,Berlin,Germany
,
Youngmin Kwon
Affiliations:
Pharmerit International,Bethesda,United States
,
Shelby Corman
Affiliations:
Pharmerit International,Bethesda,United States
,
Athanasios Zomas
Affiliations:
Takeda Pharmaceuticals International AG,Glattpark-Opfikon,Switzerland
,
Karthik Ramasamy
Affiliations:
Oxford University Hospitals,Oxford,United Kingdom
,
Francisco Gonzalez
Affiliations:
Takeda Pharmaceuticals International AG,Glattpark-Opfikon,Switzerland
Mohamad Mohty
Affiliations:
Institut national de la santé et de la recherche médicale,Paris,France
EHA Library. Romanus D. Jun 15, 2019; 267028; PS1411
Dr. Dorothy Romanus
Dr. Dorothy Romanus
Contributions
Abstract

Abstract: PS1411

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background

An estimated 4.5-6.0 cases of multiple myeloma are newly diagnosed per 100,000 people per year in Europe, of which approximately 60% do not undergo a transplant due to advanced age, comorbidities, and/or frailty (Usmani et al., ASH 2018, Abstract 112846). Limited real-world data are available on treatment patterns and clinical outcomes in this population.

Aims

To describe patient characteristics, treatment patterns, and outcomes among nSCT patients with NDMM in France, Germany, and the UK.

Methods

Adult patients (≥18 years) with symptomatic NDMM diagnosed between January 1, 2012 and December 31, 2013 who did not undergo a frontline transplant were sampled retrospectively from 161 oncology/hematology medicine practices. Patient medical chart data were extracted from diagnosis to most recent visit/death and descriptive analyses were conducted. Pearson’s chi-square/Fisher’s test were used to test for significant differences between countries. Kaplan-Meier methods were used to estimate duration of first-line (1L) therapy (DOT), and progression-free survival (PFS).

Results

A total of 497 patients (France: 176; Germany: 156; UK: 165) were included in the study; 44% of patients were ≥75 years old and 52% were male. Patients had Eastern Cooperative Oncology Group Performance Status of >2 (43%), intermediate (55%) or frail status (27%) and Charlson comorbidity index 1 (25%) or ≥2 (47%). Few patients (5%) had peripheral neuropathy at NDMM diagnosis. For those patients with available results (92%), patients in France were more likely to be ISS stage III at diagnosis (49%) compared to Germany (40%) and the UK (26%; P<0.001). Cytogenetic risk was tested in 39% of patients in France, 10% in Germany, and 13% in the UK (P<0.001). More patients were known to have high cytogenetic risk, defined as presence of del17p, t(4;14), and/or t(14;16), in France (10%) compared to Germany (3%) and the UK (4%; P<0.001). In 1L, a proteasome inhibitor (PI) + an alkylator (alk) was the most common treatment in France (41%) and in Germany (42%), whereas it was less common in the UK (12%) where most patients received an immunomodulatory drug (IMID) + alk (53%) vs (16%) and (21%) in France and Germany, respectively. Few patients across all countries (3%) received maintenance treatment as part of 1L therapy. Median follow up from start of 1L was more than 52 months in all study countries (Table). DOT of induction therapy in 1L across the 3 countries ranged from 5.9 to 8.0 months. PFS from start of 1L was shortest in the UK (34.0 months) and longest in Germany (41.7 months).


Median Treatment and Outcomes (in Months) for 1L NDMM Treatment

 

France

N=176

Germany

N=156

UK

N=165

Follow up duration (Interquartile range)

53.0 (32.5, 59.0)

57.4 (44.2, 66.6)

52.6 (29.9, 62.7)

Duration of therapy (95% Confidence interval)

8.0 (7.4, 8.6)

6.0 (5.1, 7.3)

5.9 (5.0, 7.6)

Progression free survival (95% Confidence interval)

38.0 (30.3, 45.7)

41.7 (32.8, 43.6)

34.0 (31.0, 43.0)

Conclusion

In this study, heterogeneity in cytogenetic risk testing patterns, ISS staging at diagnosis, as well as duration of 1L and PFS was observed across the 3 European countries. Induction regimens differed significantly with PI + alk regimens being more common and IMID + alk regimens less common in France and Germany than in the UK.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Multiple myeloma, Patient, Treatment

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