FACTORS ASSOCIATED WITH TIME TO TREATMENT INITIATION FOR NEWLY-DIAGNOSED MULTIPLE MYELOMA PATIENTS IN AN ACADEMIC MEDICAL SYSTEM
Author(s)
Xujun Gu, MS1, Eberechukwu Onukwugha, MSc, PhD2, Jean A. Yared, MD3, Antal Tamas Zemplenyi, MSc, PhD4, Robert Brett McQueen, BA, MA, PhD5, Julia F. Slejko, PhD1.
1University of Maryland Baltimore, Baltimore, MD, USA, 2University of Maryland, Baltimore School of Pharmacy, Baltimore, MD, USA, 3University of Maryland School of Medicine, Baltimore, MD, USA, 4University of Colorado Skaggs School of Pharmacy and Pharmaceutical Science, Denver, CO, USA, 5University of Colorado Skaggs School of Pharmacy and Pharmaceutical Science, Aurora, CO, USA.
1University of Maryland Baltimore, Baltimore, MD, USA, 2University of Maryland, Baltimore School of Pharmacy, Baltimore, MD, USA, 3University of Maryland School of Medicine, Baltimore, MD, USA, 4University of Colorado Skaggs School of Pharmacy and Pharmaceutical Science, Denver, CO, USA, 5University of Colorado Skaggs School of Pharmacy and Pharmaceutical Science, Aurora, CO, USA.
OBJECTIVES: Real-world evidence on time to treatment initiation (TTI) for multiple myeloma (MM) therapy remains limited. Delays in TTI can adversely impact prognosis. This study aims to characterize real-world treatment patterns, identify sociodemographic and clinical determinants of TTI in newly diagnosed MM patients across a statewide academic medical system.
METHODS: Tumor registry data from six cancer centers in University of Maryland Medical System were used to conduct a retrospective cohort study of MM patients diagnosed from 2018 through 2024. Patients with smoldering myeloma, without documented treatment, or treatment initiation over 90 days were excluded. Kaplan-Meier was used to estimate TTI, defined as the date of diagnosis to frontline treatment initiation. Univariate and multivariable Cox regression were used to evaluate factors associated with TTI, with hazard ratio (HR) and 95% confidence interval (CI) reported. Sociodemographic factors included age, sex, race, marital status, and insurance status. Clinical factors included cytogenetics, serum albumin, β2-microglobulin, and lactate dehydrogenase (LDH) levels.
RESULTS: Among 601 patients, median TTI was 27 days (95% CI: 25-30), and 12% (95% CI: 9.6%-14.9%) remained untreated by day 60. Significant univariate associations included age and all clinical factors. In multivariable Cox models, patients aged 50-64 years initiated treatment earlier than those aged >= 65 years (HR = 1.57, 95% CI: 1.06-2.33). High-risk cytogenetics were associated with earlier treatment compared with non-high-risk status (HR = 1.60, 95% CI: 1.16-2.21). Increasing β2-microglobulin levels were also associated with shorter TTI, with significant effects for moderate (HR = 1.57, 95% CI: 1.03-2.39) and high levels (HR = 1.61, 95% CI: 1.13-2.31).
CONCLUSIONS: TTI for MM was rapid and driven primarily by clinical severity rather than studied socioeconomic characteristics, suggesting relatively equitable access to initial treatment within the medical system. Future research should assess generalizability and long-term outcomes.
METHODS: Tumor registry data from six cancer centers in University of Maryland Medical System were used to conduct a retrospective cohort study of MM patients diagnosed from 2018 through 2024. Patients with smoldering myeloma, without documented treatment, or treatment initiation over 90 days were excluded. Kaplan-Meier was used to estimate TTI, defined as the date of diagnosis to frontline treatment initiation. Univariate and multivariable Cox regression were used to evaluate factors associated with TTI, with hazard ratio (HR) and 95% confidence interval (CI) reported. Sociodemographic factors included age, sex, race, marital status, and insurance status. Clinical factors included cytogenetics, serum albumin, β2-microglobulin, and lactate dehydrogenase (LDH) levels.
RESULTS: Among 601 patients, median TTI was 27 days (95% CI: 25-30), and 12% (95% CI: 9.6%-14.9%) remained untreated by day 60. Significant univariate associations included age and all clinical factors. In multivariable Cox models, patients aged 50-64 years initiated treatment earlier than those aged >= 65 years (HR = 1.57, 95% CI: 1.06-2.33). High-risk cytogenetics were associated with earlier treatment compared with non-high-risk status (HR = 1.60, 95% CI: 1.16-2.21). Increasing β2-microglobulin levels were also associated with shorter TTI, with significant effects for moderate (HR = 1.57, 95% CI: 1.03-2.39) and high levels (HR = 1.61, 95% CI: 1.13-2.31).
CONCLUSIONS: TTI for MM was rapid and driven primarily by clinical severity rather than studied socioeconomic characteristics, suggesting relatively equitable access to initial treatment within the medical system. Future research should assess generalizability and long-term outcomes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD160
Topic
Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology