Using LiveSLR Platform to Evaluate the Impact of Duration of Treatment (DOT) on Progression Free Survival (PFS) in Multiple Myeloma (MM)

OBJECTIVES:

Despite the innovation of newer agents, MM remains an incurable cancer. We investigated whether optimizing DOT would improve outcomes for patients with transplant-ineligible newly-diagnosed MM (TIE-NDMM), transplant-eligible NDMM with maintenance therapy (TE-NDMM-M), and relapsed/refractory MM (RRMM).

METHODS:

LiveSLR® library containing up-to-date SLRs of interventional and observational, or real-world evidence (RWE), studies in TIE-NDMM, TE-NDMM-M, and RRMM were utilized to investigate the impact of DOT on PFS. SLRs were performed following PRISMA guidelines and contained studies published in EMBASE, MEDLINE, and Cochrane 2010-Jan/2022. AI-aided study review allowed for frequent SLR updates. Extracted data from included studies were loaded onto the LiveSLR® interactive platform to aid the qualitative summary and interpretation.

RESULTS:

From a total of 43,639 citations, 89 records from 65 original studies were included in the analysis.

Among TIE-NDMM interventional studies, three provided DOT data, two showing significantly longer PFS with longer DOT. One study demonstrated significant improvement in PFS with maintenance. One RWE study showed significant improvement in PFS with continuous treatment. One meta-analysis concluded that maintenance increased PFS vs. observation.

Overall, 8/9 TE-NDMM-M interventional studies reporting PFS data, demonstrated significant PFS/event-free-survival improvement with maintenance. Fifteen of 28 RWE studies comparing maintenance therapy to observation, reported significant PFS improvement. Two RWE studies demonstrated significant increase in PFS with maintenance.

Among 7 mixed population studies (TIE-NDMM/TE-NDMM-M), 6 showed PFS improvement.

One of 2 identified RRMM interventional studies showed significantly longer PFS with single agent maintenance therapy vs. fixed duration. No RWE studies met eligibility requirements.

CONCLUSIONS:

This is the first SLR analyzing the impact of DOT on MM survival. Utilizing LiveSLR library/platform allowed for rapid analysis of up-to-date evidence, suggesting that MM patients might benefit from continuous treatment; however, the results should be interpreted with caution as this analysis included studies with various induction regimens and pooled TIE/TE patients.