SYSTEMATIC LITERATURE REVIEW OF REAL-WORLD EVIDENCE IN RELAPSED AND/OR REFRACTORY MULTIPLE MYELOMA
Author(s)
Robert M. Rifkin, MD, FACP1, Yan Zhang, PhD2, Dasha Cherepanov, PhD3, Maria Rizzo, MSc4, Sarah King, MPP5, Theresa Schweizer, PhD6, Luis G. Hernandez, PhD, MPH, MSc2;
1UCHealth / Yampa Valley Medical Center, Steamboat Springs, CO, USA, 2Takeda Pharmaceuticals America, Inc., Lexington, MA, USA, 3Takeda Development Center Americas, Inc., Cambridge, MA, USA, 4GIPAM, London, United Kingdom, 5GIPAM, Houston, TX, USA, 6GIPAM, Wismar, Germany
1UCHealth / Yampa Valley Medical Center, Steamboat Springs, CO, USA, 2Takeda Pharmaceuticals America, Inc., Lexington, MA, USA, 3Takeda Development Center Americas, Inc., Cambridge, MA, USA, 4GIPAM, London, United Kingdom, 5GIPAM, Houston, TX, USA, 6GIPAM, Wismar, Germany
OBJECTIVES: This systematic literature review aimed to evaluate the comparative effectiveness, health-related quality of life (HRQL), treatment preferences, and economic burden associated with lenalidomide plus dexamethasone (Rd)-based triplet regimens in relapsed and/or refractory multiple myeloma (RRMM).
METHODS: This review followed the Cochrane Handbook and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO registration: CRD420251136008). MEDLINE and EMBASE were searched via Ovid for studies published between 1/1/2015 and 7/18/2025. Two reviewers independently screened studies and validated all extracted data. Results were summarized qualitatively, as a robust meta-analysis was not feasible due to heterogeneity in outcome reporting, adjustment methods, and covariate selection in the included studies.
RESULTS: Searches yielded 7,569 records, of which 17 unique studies (23 reports) met the inclusion criteria. Across unique studies, carfilzomib-Rd (KRd) was evaluated most frequently (n = 17), followed by ixazomib-Rd (IRd) and daratumumab-Rd (DRd) (n = 13 each), bortezomib-Rd (VRd; n = 9), and elotuzumab-Rd (ERd; n = 5). Eight studies reported only descriptive (unadjusted) results. Adjusted overall survival (OS) was generally comparable across regimens; only one study reported any statistically significant differences (shorter OS for DRd versus KRd and for VRd versus KRd). No statistically significant differences in overall response rate were observed. IRd demonstrated fewer outpatient visits and significantly lower total, medical, and outpatient costs compared with DRd and KRd. DRd was associated with longer adjusted duration of therapy and progression-free survival. No comparative evidence on HRQL or treatment preferences was identified.
CONCLUSIONS: Real-world evidence indicates that IRd provides effectiveness comparable to other Rd-based triplet regimens while offering lower healthcare costs and fewer outpatient visits, supporting its value as a treatment option in routine practice for RRMM. As new comparative evidence continues to emerge, robust meta-analyses are granted to confirm these findings.
METHODS: This review followed the Cochrane Handbook and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO registration: CRD420251136008). MEDLINE and EMBASE were searched via Ovid for studies published between 1/1/2015 and 7/18/2025. Two reviewers independently screened studies and validated all extracted data. Results were summarized qualitatively, as a robust meta-analysis was not feasible due to heterogeneity in outcome reporting, adjustment methods, and covariate selection in the included studies.
RESULTS: Searches yielded 7,569 records, of which 17 unique studies (23 reports) met the inclusion criteria. Across unique studies, carfilzomib-Rd (KRd) was evaluated most frequently (n = 17), followed by ixazomib-Rd (IRd) and daratumumab-Rd (DRd) (n = 13 each), bortezomib-Rd (VRd; n = 9), and elotuzumab-Rd (ERd; n = 5). Eight studies reported only descriptive (unadjusted) results. Adjusted overall survival (OS) was generally comparable across regimens; only one study reported any statistically significant differences (shorter OS for DRd versus KRd and for VRd versus KRd). No statistically significant differences in overall response rate were observed. IRd demonstrated fewer outpatient visits and significantly lower total, medical, and outpatient costs compared with DRd and KRd. DRd was associated with longer adjusted duration of therapy and progression-free survival. No comparative evidence on HRQL or treatment preferences was identified.
CONCLUSIONS: Real-world evidence indicates that IRd provides effectiveness comparable to other Rd-based triplet regimens while offering lower healthcare costs and fewer outpatient visits, supporting its value as a treatment option in routine practice for RRMM. As new comparative evidence continues to emerge, robust meta-analyses are granted to confirm these findings.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO107
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Oncology, STA: Biologics & Biosimilars