Second- and third-line treatment strategies in multiple myeloma: a referral-center experience
Abstract 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; 3...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2022-12-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-022-00757-8 |
| _version_ | 1811204045968244736 |
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| author | Sarah Goldman-Mazur Alissa Visram S. Vincent Rajkumar Prashant Kapoor Angela Dispenzieri Martha Q. Lacy Morie A. Gertz Francis K. Buadi Suzanne R. Hayman David Dingli Taxiarchis Kourelis Wilson Gonsalves Rahma Warsame Eli Muchtar Nelson Leung Robert A. Kyle Shaji K. Kumar |
| author_facet | Sarah Goldman-Mazur Alissa Visram S. Vincent Rajkumar Prashant Kapoor Angela Dispenzieri Martha Q. Lacy Morie A. Gertz Francis K. Buadi Suzanne R. Hayman David Dingli Taxiarchis Kourelis Wilson Gonsalves Rahma Warsame Eli Muchtar Nelson Leung Robert A. Kyle Shaji K. Kumar |
| author_sort | Sarah Goldman-Mazur |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-12T03:04:48Z |
| format | Article |
| id | doaj.art-5e9ecee209e245c3b66b41676099aaf1 |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-04-12T03:04:48Z |
| publishDate | 2022-12-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-5e9ecee209e245c3b66b41676099aaf12022-12-22T03:50:32ZengNature Publishing GroupBlood Cancer Journal2044-53852022-12-0112121610.1038/s41408-022-00757-8Second- and third-line treatment strategies in multiple myeloma: a referral-center experienceSarah Goldman-Mazur0Alissa Visram1S. Vincent Rajkumar2Prashant Kapoor3Angela Dispenzieri4Martha Q. Lacy5Morie A. Gertz6Francis K. Buadi7Suzanne R. Hayman8David Dingli9Taxiarchis Kourelis10Wilson Gonsalves11Rahma Warsame12Eli Muchtar13Nelson Leung14Robert A. Kyle15Shaji K. Kumar16Division of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Nephrology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterAbstract 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.https://doi.org/10.1038/s41408-022-00757-8 |
| spellingShingle | Sarah Goldman-Mazur Alissa Visram S. Vincent Rajkumar Prashant Kapoor Angela Dispenzieri Martha Q. Lacy Morie A. Gertz Francis K. Buadi Suzanne R. Hayman David Dingli Taxiarchis Kourelis Wilson Gonsalves Rahma Warsame Eli Muchtar Nelson Leung Robert A. Kyle Shaji K. Kumar Second- and third-line treatment strategies in multiple myeloma: a referral-center experience Blood Cancer Journal |
| title | Second- and third-line treatment strategies in multiple myeloma: a referral-center experience |
| title_full | Second- and third-line treatment strategies in multiple myeloma: a referral-center experience |
| title_fullStr | Second- and third-line treatment strategies in multiple myeloma: a referral-center experience |
| title_full_unstemmed | Second- and third-line treatment strategies in multiple myeloma: a referral-center experience |
| title_short | Second- and third-line treatment strategies in multiple myeloma: a referral-center experience |
| title_sort | second and third line treatment strategies in multiple myeloma a referral center experience |
| url | https://doi.org/10.1038/s41408-022-00757-8 |
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