REAL-WORLD MULTIPLE MYELOMA TREATMENT RESPONSES: EVALUATION OF FRONTLINE REGIMENS IN MELDTM LINKED MEDICARE, LABORATORY AND ELECTRONIC MEDICAL RECORDS...
Author(s)
Onur Baser, MA, MS, PhD1, Katarzyna Rodchenko, MA, MPH2, Lixuan Wu, MS3, Shuangrui Chen, MS3, Nehir Yapar, BS3;
1City University of New York (CUNY), New York, NY, USA, 2Columbia Data Analytics, Analyst, New York, NY, USA, 3Columbia Data Analytics, New York, NY, USA
1City University of New York (CUNY), New York, NY, USA, 2Columbia Data Analytics, Analyst, New York, NY, USA, 3Columbia Data Analytics, New York, NY, USA
OBJECTIVES: Multiple myeloma (MM) is common in older adults and remains a major source of morbidity and cost in the Medicare population despite modern combination regimens. This analysis compared real-world hematologic and myeloma-specific laboratory responses across frontline MM regimens among Medicare fee-for-service (FFS) beneficiary claims linked with laboratory results and EMR data, enabling a complete assessment of real-world treatment response than claims only.
METHODS: A retrospective cohort of Medicare FFS beneficiaries ≥65 years with newly diagnosed MM (2021-2025) was built from the Medicare-Enhanced Lab and Demographics (MELDTM) dataset (100% Medicare claims deterministically linked to EMR). Baseline and 12‑month laboratory tests included hemoglobin, creatinine/estimated glomerular filtration rate (eGFR), calcium, albumin, β2‑microglobulin, LDH, quantitative immunoglobulins, serum free light chains, and serum protein electrophoresis (SPEP) M‑protein. Patients were categorized by frontline regimen (contemporary triplet/quadruplet vs less‑intensive doublet/other). Outcomes were 12‑month changes in M‑protein, free light chain difference, hemoglobin, and renal function, and achievement of laboratory profiles consistent with at least very good partial response (≥VGPR‑like) or complete response (CR‑like).
RESULTS: Incident beneficiaries with MM (~35,000) had mean age 76 years with frequent baseline anemia and renal impairment. In triplet/quadruplet recipients, mean M‑protein declined (~3.2 to 0.4g/dL) and free light chain difference from ~125 to 18mg/L; hemoglobin rising from ~9.7 to 11.6g/dL; less‑intensive regimens showed smaller changes (M‑protein ~2.9 to 1.1g/dL, light chains ~118 to 45mg/L, hemoglobin ~9.9 to 10.7g/dL). Of triplet/quadruplet patients, ~58% reached ≥VGPR‑like and 28% CR‑like profiles at 12 months vs 34%, and 12% with less‑intensive therapy. Renal function improved more with intensive regimens, with larger eGFR gains and fewer patients remaining at eGFR <30 mL/min/1.73 m².
CONCLUSIONS: Our result showed that contemporary triplet/quadruplet regimens yield deeper laboratory responses and greater renal recovery than less‑intensive regimens, supporting the benefit of modern combination therapy for real‑world disease control in older adults.
METHODS: A retrospective cohort of Medicare FFS beneficiaries ≥65 years with newly diagnosed MM (2021-2025) was built from the Medicare-Enhanced Lab and Demographics (MELDTM) dataset (100% Medicare claims deterministically linked to EMR). Baseline and 12‑month laboratory tests included hemoglobin, creatinine/estimated glomerular filtration rate (eGFR), calcium, albumin, β2‑microglobulin, LDH, quantitative immunoglobulins, serum free light chains, and serum protein electrophoresis (SPEP) M‑protein. Patients were categorized by frontline regimen (contemporary triplet/quadruplet vs less‑intensive doublet/other). Outcomes were 12‑month changes in M‑protein, free light chain difference, hemoglobin, and renal function, and achievement of laboratory profiles consistent with at least very good partial response (≥VGPR‑like) or complete response (CR‑like).
RESULTS: Incident beneficiaries with MM (~35,000) had mean age 76 years with frequent baseline anemia and renal impairment. In triplet/quadruplet recipients, mean M‑protein declined (~3.2 to 0.4g/dL) and free light chain difference from ~125 to 18mg/L; hemoglobin rising from ~9.7 to 11.6g/dL; less‑intensive regimens showed smaller changes (M‑protein ~2.9 to 1.1g/dL, light chains ~118 to 45mg/L, hemoglobin ~9.9 to 10.7g/dL). Of triplet/quadruplet patients, ~58% reached ≥VGPR‑like and 28% CR‑like profiles at 12 months vs 34%, and 12% with less‑intensive therapy. Renal function improved more with intensive regimens, with larger eGFR gains and fewer patients remaining at eGFR <30 mL/min/1.73 m².
CONCLUSIONS: Our result showed that contemporary triplet/quadruplet regimens yield deeper laboratory responses and greater renal recovery than less‑intensive regimens, supporting the benefit of modern combination therapy for real‑world disease control in older adults.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO144
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy
Disease
SDC: Oncology