A Real-World Study of Multiple Myeloma Patients With at Least 3 Prior Treatment Lines and Triple Class Exposed Disease in Finland: Outcomes and Need for Healthcare Resource Use

OBJECTIVES: Patients with Multiple myeloma (MM) having ≥3 prior treatment lines and triple class exposed (TCE) disease face a significant medical challenge. Despite advances in MM care, outcomes of those patients remain poor. Healthcare resource use (HCRU) of this population is unknown.

METHODS: In this retrospective real-world study, we examined TCE MM patients diagnosed in Finland between 2013 and 2022. Patients were identified and data collected from four hospital data lakes and national registries. Cohort was formed of MM patients with ≥3 prior treatment lines and exposure to proteasome inhibitor, immunomodulatory drug, and anti-CD38 antibody. Overall survival (OS), time to next treatment (TTNT) and HCRU were analyzed.

RESULTS: We identified 51 TCE patients with a median age of 66.8 years (IQR 60.3-72.6) at TCE. Altogether 21 patients (41.2%) were female, and 38 patients (74.5%) had 3-4 prior treatment lines. Median TTNT and OS were 4.4 months (95% CI 3.3-8.6) and 10.3 months (95% CI 7.4-17.9), respectively. During the specialized care, TCE patients had six outpatient contacts (95% CI 4-7) and two inpatient days (95% CI 1-3) per patient month (PPM), and at primary care two contacts (95% CI 1-4) PPM compared to all treated MM patients with corresponding values of three (95% CI 3-3), one (95% CI 1-1), and four (95% CI 4-5), respectively. The corresponding PPM costs were 4002€ (95% CI 3012-5379) for the TCE cohort and 2139€ (95% CI 2054-2223) for the whole MM cohort.

CONCLUSIONS: This study indicates that real-world MM patients having TCE disease and ≥3 prior treatment lines used exhibit short TTNT and survival and excess need for HCRU. These findings underscore the vulnerable position of patients with TCE disease, and the need for more effective treatment strategies for this patient population.