PS1411 CHARACTERISTICS AND TREATMENT OUTCOMES OF NEWLY DIAGNOSED MULTIPLE MYELOMA (NDMM) NON‐STEM CELL TRANSPLANT (NSCT) PATIENTS IN THE UK, GERMANY, AND FRANCE
Authors: Knauf W. , Romanus D. , Cambron‐Mellott M.J. , Vikis H.G. , Cherepanov D. , Verleger K. , Kwon Y. , Corman S. , Zomas A. , Ramasamy K. , Gonzalez F. , Mohty M. 
Published: June 2019

Background:

An estimated 4.5–6.0 cases of multiple myeloma are newly diagnosed per 100,000 people per year in Europe, of which approximately 60% do not undergo a transplant due to advanced age, comorbidities, and/or frailty (Usmani et al., ASH 2018, Abstract 112846). Limited real‐world data are available on treatment patterns and clinical outcomes in this population.

Aims:

To describe patient characteristics, treatment patterns, and outcomes among nSCT patients with NDMM in France, Germany, and the UK.

Methods:

Adult patients (≥18 years) with symptomatic NDMM diagnosed between January 1, 2012 and December 31, 2013 who did not undergo a frontline transplant were sampled retrospectively from 161 oncology/hematology medicine practices. Patient medical chart data were extracted from diagnosis to most recent visit/death and descriptive analyses were conducted. Pearson's chi‐square/Fisher's test were used to test for significant differences between countries. Kaplan‐Meier methods were used to estimate duration of first‐line (1L) therapy (DOT), and progression‐free survival (PFS).

Results:

A total of 497 patients (France: 176; Germany: 156; UK: 165) were included in the study; 44% of patients were ≥75 years old and 52% were male. Patients had Eastern Cooperative Oncology Group Performance Status of ≥2 (43%), intermediate (55%) or frail status (27%) and Charlson comorbidity index 1 (25%) or ≥2 (47%). Few patients (5%) had peripheral neuropathy at NDMM diagnosis. For those patients with available results (92%), patients in France were more likely to be ISS stage III at diagnosis (49%) compared to Germany (40%) and the UK (26%; P < 0.001). Cytogenetic risk was tested in 39% of patients in France, 10% in Germany, and 13% in the UK (P < 0.001). More patients were known to have high cytogenetic risk, defined as presence of del17p, t(4;14), and/or t(14;16), in France (10%) compared to Germany (3%) and the UK (4%; P < 0.001). In 1L, a proteasome inhibitor (PI) + an alkylator (alk) was the most common treatment in France (41%) and in Germany (42%), whereas it was less common in the UK (12%) where most patients received an immunomodulatory drug (IMID) + alk (53%) vs (16%) and (21%) in France and Germany, respectively. Few patients across all countries (3%) received maintenance treatment as part of 1L therapy. Median follow up from start of 1L was more than 52 months in all study countries (Table). DOT of induction therapy in 1L across the 3 countries ranged from 5.9 to 8.0 months. PFS from start of 1L was shortest in the UK (34.0 months) and longest in Germany (41.7 months).

Median Treatment and Outcomes (in Months) for 1L NDMM Treatment

Summary/Conclusion:

In this study, heterogeneity in cytogenetic risk testing patterns, ISS staging at diagnosis, as well as duration of 1L and PFS was observed across the 3 European countries. Induction regimens differed significantly with PI + alk regimens being more common and IMID + alk regimens less common in France and Germany than in the UK.

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