Localizing a Sequencing Model Using Patient-Level Data to Optimize Outcomes in the First Line of Treatment for Multiple Myeloma in Greece
Author(s)
Timoleon Konstantinos Christodoulou, PharmD, MSc1, CHRISTINA GOLNA, LLM, MSc2, Pavlos Golnas, MSc2, Danai Kourmpani, PharmD, MSc1, Kyriakos Souliotis, PhD3.
1Johnson & Johnson Innovative Medicine, Athens, Greece, 2Health Policy Institute, Maroussi, Greece, 3School of Social and Political Sciences, University of Peloponnese, Corinth, Greece.
1Johnson & Johnson Innovative Medicine, Athens, Greece, 2Health Policy Institute, Maroussi, Greece, 3School of Social and Political Sciences, University of Peloponnese, Corinth, Greece.
OBJECTIVES: Evaluate the impact of optimizing treatment sequences in transplant-eligible (TE) and transplant-ineligible (TIE) multiple myeloma (MM) patients through a health-state transition sequencing model adapted to the Greek local clinical landscape.
METHODS: The sequencing model simulates and compares expected survival outcomes between treatment sequences in the TE and TIE setting. Newly diagnosed patients start a first line treatment and at relapse the patient transitions to a subsequent treatment line, up to a maximum of four treatment lines. Patients can transition directly to the death state from any treatment line. Clinical efficacy data considers randomized clinical trial data and indirect evidence (network meta-analyses and matched adjusted indirect comparisons). Treatment sequences were defined and validated based on Greek data to reflect current local clinical practice. Model outputs include average OS and average PFS per line of treatment for each treatment sequence.
RESULTS: In both settings (1L TE and 1L TIE), sequences with daratumumab in frontline showed the longest average overall survival for patients. Efficacy in frontline was the driver of the extended survival outcomes. More specifically, in 1L TE MM patients, DVTd with Len+PVd+Kd+teclistamab and DVTd with Len+ DKd+PVd+Teclistamab yielded 13.42 years in 1L vs 8.40 and 8.17 for VRd with Len+DKd+PVd+teclistamab, and VTd with Len+DKd+PVd+teclistamab and VTd with Len+IsaKd+PVd+teclistamab respectively. In 1L TIE MM patients, DRd+PVd+ Kd+Teclistamab yielded 7.48 years vs. 5.36 for VRd+DKd+PVd+teclistamab and VRd+IsaKd+PVd+teclistamab, and 4.13 years for Rd+PVd+IsaKd+teclistamab and Rd+DVd+KRd+teclistamab.
CONCLUSIONS: Efficacy and time on treatment in 1L are the strongest drivers of improved long-term outcomes in patients with MM. The addition of daratumumab in treatment combinations in the 1L of treatment for both TE and TIE MM patients substantially prolongs time spent in 1L and OS.
METHODS: The sequencing model simulates and compares expected survival outcomes between treatment sequences in the TE and TIE setting. Newly diagnosed patients start a first line treatment and at relapse the patient transitions to a subsequent treatment line, up to a maximum of four treatment lines. Patients can transition directly to the death state from any treatment line. Clinical efficacy data considers randomized clinical trial data and indirect evidence (network meta-analyses and matched adjusted indirect comparisons). Treatment sequences were defined and validated based on Greek data to reflect current local clinical practice. Model outputs include average OS and average PFS per line of treatment for each treatment sequence.
RESULTS: In both settings (1L TE and 1L TIE), sequences with daratumumab in frontline showed the longest average overall survival for patients. Efficacy in frontline was the driver of the extended survival outcomes. More specifically, in 1L TE MM patients, DVTd with Len+PVd+Kd+teclistamab and DVTd with Len+ DKd+PVd+Teclistamab yielded 13.42 years in 1L vs 8.40 and 8.17 for VRd with Len+DKd+PVd+teclistamab, and VTd with Len+DKd+PVd+teclistamab and VTd with Len+IsaKd+PVd+teclistamab respectively. In 1L TIE MM patients, DRd+PVd+ Kd+Teclistamab yielded 7.48 years vs. 5.36 for VRd+DKd+PVd+teclistamab and VRd+IsaKd+PVd+teclistamab, and 4.13 years for Rd+PVd+IsaKd+teclistamab and Rd+DVd+KRd+teclistamab.
CONCLUSIONS: Efficacy and time on treatment in 1L are the strongest drivers of improved long-term outcomes in patients with MM. The addition of daratumumab in treatment combinations in the 1L of treatment for both TE and TIE MM patients substantially prolongs time spent in 1L and OS.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD69
Topic
Clinical Outcomes, Health Service Delivery & Process of Care
Disease
Oncology