TY - JOUR
T1 - Second- and third-line treatment strategies in multiple myeloma
T2 - a referral-center experience
AU - Goldman-Mazur, Sarah
AU - Visram, Alissa
AU - Rajkumar, S. Vincent
AU - Kapoor, Prashant
AU - Dispenzieri, Angela
AU - Lacy, Martha Q.
AU - Gertz, Morie A.
AU - Buadi, Francis K.
AU - Hayman, Suzanne R.
AU - Dingli, David
AU - Kourelis, Taxiarchis
AU - Gonsalves, Wilson
AU - Warsame, Rahma
AU - Muchtar, Eli
AU - Leung, Nelson
AU - Kyle, Robert A.
AU - Kumar, Shaji K.
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - The treatment landscape for relapsed multiple myeloma (MM) has increased. In this study, we aimed to characterize 2nd (n = 1439) and 3rd (n = 1104) line regimens and compare the results between subgroups based on the year of treatment initiation (2nd line: 2003–2008, 2009–2015, 2016–2021; 3rd line: 2004–2009, 2010–2015, and 2016–2021). In both the second- and third- lines, we observed increasing use of novel agents (from 78 to 95% and from 77 to 95%, respectively) and triplet regimens (from 15 to 69% and from 21 to 71%, respectively). The most frequently used regimens in the last studied periods included lenalidomide-dexamethasone (RD; 14%), carfilzomib-RD (12%), and daratumumab-RD (10%) for the second-line, and daratumumab-pomalidomide-dexamethasone (11%) and daratumumab-RD (10%) for the third-line. The median time to the next treatment from second-line therapy has improved from 10.4 months (95% CI: 8.4–12.4) to 16.6 months (95% CI: 13.3–20.3; p < 0.001). The median overall survival from the first relapse increased from 30.9 months (95% CI: 26.8–183.0) to 65.8 months (95% CI: 50.7–72.8; p < 0.001). Over the last two decades, more patients were treated with newer agents and triplets for relapsed MM. The landscape of regimens has become more diverse, and survival after the first relapse is continually improving. [Figure not available: see fulltext.]
AB - The treatment landscape for relapsed multiple myeloma (MM) has increased. In this study, we aimed to characterize 2nd (n = 1439) and 3rd (n = 1104) line regimens and compare the results between subgroups based on the year of treatment initiation (2nd line: 2003–2008, 2009–2015, 2016–2021; 3rd line: 2004–2009, 2010–2015, and 2016–2021). In both the second- and third- lines, we observed increasing use of novel agents (from 78 to 95% and from 77 to 95%, respectively) and triplet regimens (from 15 to 69% and from 21 to 71%, respectively). The most frequently used regimens in the last studied periods included lenalidomide-dexamethasone (RD; 14%), carfilzomib-RD (12%), and daratumumab-RD (10%) for the second-line, and daratumumab-pomalidomide-dexamethasone (11%) and daratumumab-RD (10%) for the third-line. The median time to the next treatment from second-line therapy has improved from 10.4 months (95% CI: 8.4–12.4) to 16.6 months (95% CI: 13.3–20.3; p < 0.001). The median overall survival from the first relapse increased from 30.9 months (95% CI: 26.8–183.0) to 65.8 months (95% CI: 50.7–72.8; p < 0.001). Over the last two decades, more patients were treated with newer agents and triplets for relapsed MM. The landscape of regimens has become more diverse, and survival after the first relapse is continually improving. [Figure not available: see fulltext.]
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U2 - 10.1038/s41408-022-00757-8
DO - 10.1038/s41408-022-00757-8
M3 - Article
C2 - 36473843
AN - SCOPUS:85143372213
SN - 2044-5385
VL - 12
JO - Blood cancer journal
JF - Blood cancer journal
IS - 12
M1 - 164
ER -