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PATIENT CHARACTERISTICS, TREATMENT PATTERNS AND OUTCOMES IN PATIENTS WITH TRIPLE CLASS REFRACTORY MULTIPLE MYELOMA
Author(s): ,
Maneesha Mehra
Affiliations:
Janssen Global Services, LLC,Raritan,United States
,
Martin Vogel
Affiliations:
Janssen-Cilag GmbH,Neuss,Germany
,
Satish Valluri
Affiliations:
Janssen Global Services, LLC,Raritan,United States
,
Sandhya Nair
Affiliations:
Janssen Global Services, LLC,Raritan,United States
,
Jordan Schecter
Affiliations:
Janssen Research & Development,Raritan,United States
,
Rafal Slowik
Affiliations:
Janssen Global Services, LLC,Raritan,United States
,
Sundar Jagannath
Affiliations:
Mt Sinai Hospital,New York,United States
,
Katja C. Weisel
Affiliations:
University Medical Center of Hamburg-Eppendorf,Hamburg,Germany
Saad Usmani
Affiliations:
Levine Cancer Institute/Atrium Health,Charlotte,United States
(Abstract release date: 05/14/20) EHA Library. Mehra M. 06/12/20; 293522; EP1032
Maneesha Mehra
Maneesha Mehra
Contributions
Abstract

Abstract: EP1032

Type: e-Poster

Background
In recent years, several new treatment combinations using proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs) and anti-CD38 monoclonal antibodies (mAbs) such as daratumumab have become available, leading to significantly improved survival outcomes in patients with multiple myeloma (MM). Now, multiple novel agents (Chimeric Antigen Receptor T-Cell therapy, antibody-drug conjugates, and bi-specifics) are being tested in patients with MM who have been exposed and/or are refractory to these 3 classes (triple class refractory, TCR). However, limited data are available characterizing treatments and outcomes in this population.

Aims
To explore outcomes among TCR patients with RRMM in a real-world treatment setting.

Methods
Data from triple-exposed patients with RRMM from the Flatiron Health electronic health record (EHR)-derived deidentified database (Jan 2011 - Oct 2019) who received ≥3 prior lines of therapy (LOT) were used for the analyses. TCR status was derived using a validated algorithm (Usmani S, et al. The Oncologist 2016;21:1355-61). The time point at which patients started the first LOT after achieving TCR status was referred to as T0 or the index date. Descriptive statistics for patient characteristics were assessed at T0. Time to event analyses for progression-free survival (PFS), defined as progression or death whichever is first after TCR, (patients censored at start of subsequent treatment or last visit date whichever came first), Time to Next Treatment (TTNT) and overall survival (OS) were analyzed using the Kaplan Meier method and were assessed starting at T0.

Results
From the >10,000 patients with MM, 251 TCR patients with a subsequent LOT were identified and analyzed. Median age at TCR was 68 years; median follow-up from start of subsequent LOT was 6 months (interquartile range: 2.7, 10.8). Patient characteristics are presented in the table. 93% of patients were on a daratumumab-containing regimen at TCR. Most common subsequent treatment regimen after achieving TCR status were elotuzumab-, pomalidomide-, and carfilzomib- containing regimens. Median (95% confidence interval [CI]) PFS and OS from T0 was 4.8 (3.7–6.1) and 11.0 (8.7–13.6) months, respectively. Median (95% CI) TTNT was 5.6 (4.5-6.4) months.

Conclusion
This analysis of EHR data from the Flatiron Health database demonstrates that in triple class refractory patients with RRMM, outcomes are poor and there is a need for novel treatments that can improve response and survival. Results were consistent with other research (Gandhi UH, et al. Leukemia 2019;33:2266-75).

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

Keyword(s): Cancer immunotherapy, Multiple myeloma, Refractory

Abstract: EP1032

Type: e-Poster

Background
In recent years, several new treatment combinations using proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs) and anti-CD38 monoclonal antibodies (mAbs) such as daratumumab have become available, leading to significantly improved survival outcomes in patients with multiple myeloma (MM). Now, multiple novel agents (Chimeric Antigen Receptor T-Cell therapy, antibody-drug conjugates, and bi-specifics) are being tested in patients with MM who have been exposed and/or are refractory to these 3 classes (triple class refractory, TCR). However, limited data are available characterizing treatments and outcomes in this population.

Aims
To explore outcomes among TCR patients with RRMM in a real-world treatment setting.

Methods
Data from triple-exposed patients with RRMM from the Flatiron Health electronic health record (EHR)-derived deidentified database (Jan 2011 - Oct 2019) who received ≥3 prior lines of therapy (LOT) were used for the analyses. TCR status was derived using a validated algorithm (Usmani S, et al. The Oncologist 2016;21:1355-61). The time point at which patients started the first LOT after achieving TCR status was referred to as T0 or the index date. Descriptive statistics for patient characteristics were assessed at T0. Time to event analyses for progression-free survival (PFS), defined as progression or death whichever is first after TCR, (patients censored at start of subsequent treatment or last visit date whichever came first), Time to Next Treatment (TTNT) and overall survival (OS) were analyzed using the Kaplan Meier method and were assessed starting at T0.

Results
From the >10,000 patients with MM, 251 TCR patients with a subsequent LOT were identified and analyzed. Median age at TCR was 68 years; median follow-up from start of subsequent LOT was 6 months (interquartile range: 2.7, 10.8). Patient characteristics are presented in the table. 93% of patients were on a daratumumab-containing regimen at TCR. Most common subsequent treatment regimen after achieving TCR status were elotuzumab-, pomalidomide-, and carfilzomib- containing regimens. Median (95% confidence interval [CI]) PFS and OS from T0 was 4.8 (3.7–6.1) and 11.0 (8.7–13.6) months, respectively. Median (95% CI) TTNT was 5.6 (4.5-6.4) months.

Conclusion
This analysis of EHR data from the Flatiron Health database demonstrates that in triple class refractory patients with RRMM, outcomes are poor and there is a need for novel treatments that can improve response and survival. Results were consistent with other research (Gandhi UH, et al. Leukemia 2019;33:2266-75).

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

Keyword(s): Cancer immunotherapy, Multiple myeloma, Refractory

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