Clinical and Sociodemographic Characteristics of Patients With Relapsed and/or Refractory Multiple Myeloma and Their influence on Treatment in the Real-World Setting in Spain: The CharisMMa Study

Enrique M Ocio,Carmen Montes-Gaisán,Gabriela Bustamante,Sebastián Garzón,Esther González,Ernesto Pérez,Maialen Sirvent,José María Arguiñano,Yolanda González,Rafael Ríos,Dunia De Miguel,Marta Grande,Alonso Fernández,Andrea Naves,Laura Rosiñol

doi:10.1016/j.clml.2021.10.001

Abstract

IntroductionTreatment of relapsed and/or refractory multiple myeloma (RRMM) should be established based on multiple factors, including previous treatment and the sociodemographic/clinical characteristics of the patients. However, patients enrolled in randomized-controlled trials often do not mirror the scenario encountered in real-world practice, thus challenging therapeutic decisions in day-to-day practice. Patients and methodsThis observational, cross-sectional, multicenter study aimed to investigate the sociodemographic and clinical characteristics of patients with RRMM treated in routine practice in Spain and their influence on treatment regimens. ResultsThe study included 276 RRMM patients (median age 69 years; no gender predominance). Seventy-four percent of patients had CRAB features at the time of study inclusion, 65.9% bone lesions, 28.7% high-risk cytogenetics, and 27.0% were at ISS stage III; 65.1% were retired and lived in urban areas (75.7%) with their relatives (85.8%); 28.7% had some dependence degree. Patients had experienced their last relapse in a median of 1.61 months before enrollment and had received a median of 2 treatment lines (range 1-10). Second-and third-line therapies were mostly based on immunomodulatory drugs, followed by proteasome inhibitors (PIs), whereas monoclonal antibodies prevailed in later treatment lines. The presence of extramedullary plasmacytomas, the absence of osteopenia, and being in the second or third treatment line (vs. later lines) significantly increased the odds of receiving PIs. ConclusionsRRMM treatment in the real-world setting is highly heterogeneous and is primarily influenced by the number of previous lines. The consideration of patients’ clinical and sociodemographic characteristics may support clinicians in making therapeutic decisions.

Highlights

Treatment of relapsed and/or refractory multiple myeloma (RRMM) should be established based on multiple factors, including previous treatment and the sociodemographic/clinical characteristics of the patients
Patients had experienced their last relapse in a median of 1.61 months before enrollment and had received a median of two treatment lines
Second- and third-line therapies were mostly based on immunomodulatory drugs, followed by proteasome inhibitors (PIs), whereas monoclonal antibodies prevailed in later treatment lines

Summary

Introduction

Treatment of relapsed and/or refractory multiple myeloma (RRMM) should be established based on multiple factors, including previous treatment and the sociodemographic/clinical characteristics of the patients. Multiple myeloma (MM) is the second most common hematological malignancy and accounts for 13% of all blood cancers.[1] It has been estimated that nearly 86,000 new diagnoses are made worldwide every year; the global epidemiological landscape of MM suggests an upward trend of MM incidence in developed countries, probably associated with population aging.[2] In the last decade, several advances in the understanding of the molecular basis and prognostic factors of MM, along with the advent of novel therapeutic agents, have remarkably improved the survival of these patients. The advent of novel therapies provides clinicians with more tools for improving survival in MM patients, but it increases the complexity of therapeutic decision-making, in the context of RRMM.[9]

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