Work

Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes

Year: 2024

Type: article

Abstract: OBJECTIVE: Patients with multiple myeloma (MM) typically require multiple regimens and become harder to treat with each line of treatment. Furthermore, there is a lack of direct comparative clinical trial data to guide effective treatment sequencing. A novel model is described comparing alternative MM treatment sequences to optimize patient outcomes. METHODS: The model compares treatment sequences and outcomes for adults with newly diagnosed transplant-eligible (TE) or transplant-ineligible (TIE) MM across four treatment lines (first-line [FL] to fourth-line [4L]). Inputs are derived from patient-level data from clinical trials and indirect treatment comparisons. We report a base case prediction using data representing clinical practice in Italy. RESULTS: For FL TE, overall survival (OS) and progression-free survival (PFS) were greatest for FL regimens containing daratumumab; OS ranged from 11.80-18.10 years. PFS ranged from 4.82-13.42 years (FL) to 0.66-6.03 years (second-line [2L]), 0.81-1.76 years (third-line [3L]), and 0.69-0.72 years (4L). For FL TIE, OS rates were greater for treatment sequences with FL daratumumab vs. sequences with either 2L or no daratumumab (OS ranging from 5.95-10.61 years). PFS was greatest for FL daratumumab regimens in the TIE group, with PFS ranging from 2.12-7.48 years (FL), 0.53-4.73 years (2L), 0.63-1.17 years (3L), and 0.42 years (4L). DISCUSSION: This novel model demonstrates that using the most effective treatment in FL optimizes treatment sequencing and clinical outcomes for patients. CONCLUSION: The optimal MM treatment sequences begin with daratumumab-containing regimens in FL and improve outcomes compared with alternative sequences.

Source: Hematology

DOI: 10.1080/16078454.2024.2432815

Authors: Maria Teresa Petrucci, Sara Bringhen, Cristina Entrala Cerezo, João Mendes, Patrizio Armeni

Institutions: Policlinico Umberto I, Sapienza University of Rome, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, Bocconi University

Language: English

Topic: Multiple Myeloma Research and Treatments

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,557