644P - Treatment patterns, outcomes, and physician decision-making in multiple myeloma: A real-world European study

Background

The multiple myeloma (MM) treatment (Tx) landscape is fast evolving. This study was conducted to assess current real-world (RW) Tx patterns and outcomes, including physician decision-making, in Europe (United Kingdom, France, Germany, Italy, Spain).

Methods

RW data were derived from the Adelphi MM Disease Specific Programme™, a point-in-time survey of haematologists and haemato-oncologists conducted from May to November 2021. Descriptive information on current MM Tx patterns and physician decision making were collated and analyzed by line of Tx (LOT). Patient (pt) record forms were completed by physicians for pts with confirmed MM who were actively receiving Tx (ie, quota of ≥2 pts on each LOT and triple-class exposed).

Results

A total of 256 physicians provided data for 2179 pts (median age 72 years, ISS stage III 53%, 26% had stem cell transplant [SCT, 91% at 1L]). Bortezomib (BORT, 79%) and Lenalidomide (LEN, 57%) were common agents in 1L and 2L regimens, respectively. Pomalidomide (POM) was common in 3L-4L regimens (25%-35%; Pd usage was 10%-13%). Daratumumab [DARA] was common in 2L-4L regimens (30%-32%) and varied by country. Highest rates of DARA use in Tx regimens were observed in Italy (2L 45%), Spain (3L 43%), and the UK (4L 47%). The table shows the top 5 Tx regimens by LOT in the 5 European countries combined. Efficacy was the most common reason for prescribing Tx (1L 97%, 2L 97%, 3L 94%, 4L 89%), and a manageable safety profile was common (1L 49%, 2L 35%, 3L 41%, 4L 39%). Other common reasons included national/clinical guidelines, physician familiarity, and quality of life. Table shows mDOT and mTTNT by LOT. Disease progression and refractoriness to Tx were key reasons physicians stopped Tx. Table: 644P

1L, first-line; V, BORT; CyBord, cyclophosphamide + BORT + DEX; D, DARA; DEX or d, dexamethasone; K, carfilzomib; R, LEN; Isa, isatuximab; Ixa, ixazomib; mDOT, median duration of Tx; mTTNT, median time to next Tx; P, POM; VMP, BORT + melphalan + prednisone; VTd, V + thalidomide + DEX. ^a1L induction. ^bPts ineligible for SCT at 1L (1 pt received 1L maintenance).

Conclusions

There were variances in Tx regimens used by LOT and across markets in Europe. Efficacy and safety were the main reasons for prescribing Tx, and disease progression was the main reason to stop Tx. Increasingly short mTTNT in later lines demonstrates an unmet need exists in these pts.

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. Ribbands: Employee: Adelphi Real World. A.L. Bailey: 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.