Abstract 642P
Background
To better understand the frequency and impact of retreatment (ReTx) on treatment (Tx) outcomes in patients (pts) with RRMM, we analysed the results from a real-world (RW) survey conducted in Europe.
Methods
Data were derived from the Adelphi MM Disease Specific Programme™, a point-in-time survey of haematologists and haemato-oncologists conducted from May to Nov 2021. Descriptive information on frequency, and impact of ReTx, including reasons for prescribing and stopping ReTx were analyzed across line of Tx (LOT). Pt record forms were completed by physicians for pts with confirmed MM who were actively receiving Tx (ie, a quota of ≥2 pts on each LOT and triple-class exposed).
Results
A total of 256 physicians provided data on 1778 pts with RRMM who received ≥2 LOT. ReTx with IMiDs® or proteasome inhibitors (PIs) was seen in 70% (lenalidomide [LEN] regimen ReTx only, 21%) and 62% (bortezomib [BORT] regimen ReTx only, 29%) of pts, respectively, and most often occurred in 2L or 3L (Table). In contrast, CD38- antibodies were previously used in 5% of pts (daratumumab [DARA] ReTx only, 3%). Overall, ReTx with a prior agent and/or class was similar across countries; however, LEN ReTx rates were numerically lower in the UK (10%) and Spain (11%) than Germany (35%), France (27%), and Italy (22%). Following Tx guidelines and disease progression were the primary reasons for choosing and stopping ReTx, respectively, regardless of LOT. Table shows median duration of Tx (mDOT) and median time to next Tx (mTTNT) for pts with BORT, LEN, or DARA ReTx in 2L-4L. Table: 642P
| BORT | LEN | DARA | ||||
| ReTx | No ReTx | ReTx | No ReTx | ReTx | No ReTx | |
| Overall population (≥2L; n=1778), % | 29 | 71 | 21 | 79 | 3 | 97 |
| 2L (n=1778), % | 17 | 83 | 10 | 90 | 1 | 99 |
| 3L (n=1270), % | 13 | 87 | 10 | 90 | 1 | 99 |
| 4L (n=633), % | 7 | 93 | 9 | 91 | 3 | 97 |
| mDOT a | ||||||
| 2L (n=1067) | ||||||
| % | 17 | 83 | 8 | 92 | <1 | 100 |
| months | 7.2 | 11.3 | 10.8 | 10.7 | 6.6 | 10.8 |
| 3L (n=551) | ||||||
| % | 15 | 85 | 10 | 90 | 2 | 98 |
| months | 10.8 | 10.5 | 10.0 | 10.8 | 4.0 | 10.8 |
| 4L (n=92) | ||||||
| % | 13 | 87 | 9 | 91 | 0 | 100 |
| months | 7.9 | 7.0 | 9.7 | 6.6 | – | 7.0 |
| mTTNT (start of listed line to start of next line) b | ||||||
| 2L (n=1069) | ||||||
| % | 18 | 82 | 9 | 91 | <1 | 100 |
| months | 16.1 | 16.4 | 15.0 | 16.5 | 4.4 | 16.4 |
| 3L (n=540) | ||||||
| % | 15 | 85 | 11 | 89 | 2 | 98 |
| months | 16.0 | 14.3 | 16.8 | 14.0 | 4.0 | 14.6 |
| 4L (n=68) | ||||||
| % | 16 | 84 | 9 | 91 | 0 | 100 |
| months | 13.3 | 11.7 | 12.9 | 11.8 | – | 11.9 |
aIncludes pts with known LOT start and end date. bIncludes pts with known start date of listed line and next line.
Conclusions
Consistent with ESMO guidelines, ReTx with PIs or IMiDs® was common in 2L and 3L (primarily BORT and LEN), whereas rates of DARA ReTx were low. Trends were observed with mDOT and mTTNT, suggesting some retreatment options may be suboptimal in a RW setting. The variation in ReTx patterns between countries was more prominent with LEN-based regimens compared with others.
Clinical trial identification
Editorial acknowledgement
Writing and editorial support was provided by Peter J. Simon of MediTech Media and funded by GSK.
Legal entity responsible for the study
GSK and Adelphi Real World.
Funding
GSK.
Disclosure
A.L. Bailey: Financial Interests, Other, Employee: Adelphi Real World. A. Ribbands: Financial Interests, Other, Employee: Adelphi Real World. E. Luke: Financial Interests, Other, Employee: Adelphi Real World. All other authors have declared no conflicts of interest.