MM-138: Estimating the Number of US Patients with Multiple Myeloma (MM) at Different Lines of Treatment (LOT)

Abstract

Context: The MM patient journey by LOT evolves as new treatments become available. Numbers of patients with MM by LOT are important to inform coverage and resource allocation decisions, but current estimates are lacking. Objective: To estimate the number of US patients with MM at different LOTs and identify a subgroup on their ≥4 LOT (LOT4+), including prior exposure to a proteasome inhibitor (PI), an immunomodulatory agent, and/or an anti-CD38 antibody (i.e., daratumumab). Methods: Differential equations were used to develop a four-compartment model: LOT1 through LOT4+. Patients in LOT1–LOT3 could die or transition to the next LOT. Patients in LOT4+ could remain in that compartment or die. Each LOT included four sub-compartments based on stem-cell transplant eligibility (SCT; eligible/ineligible) and treatment type (daratumumab/other). Patients could change treatment type when they transitioned to the next LOT. The model evaluated patient numbers in four strata: age (≥65/ Results: The model predicted an MM prevalence of 128,083 US patients, with 106,043 receiving treatment (LOT1: 54% [n=56,738]; LOT2: 27% [n=28,287]; LOT3: 10% [n=10,629]; LOT4+: 10% [n=10,389]). An estimated 50% (5156/10,389) of patients in LOT4+ (standard deviation=1361) had prior exposure to PIs, immunomodulatory agents, and/or anti-CD38 antibodies. LOT4+ model results were most sensitive to mortality, TTNT, and daratumumab use. Conclusions: This is one of the first estimates of the current number of US patients with MM by LOT, including the number of patients in LOT4+, accounting for newly approved regimens. Funding: GlaxoSmithKline (213290). This abstract was previously presented at the 2020 EHA 25 Congress and is presented on behalf of and with the permission of the original authors and EHA (Nikolaou A, et al. EP963).