Real-World Efficacy Outcomes for Patients With Relapsed/Refractory Multiple Myeloma (RRMM) From the Flatiron Health Database
Author(s)
Sandhya Nair, PhD1, Luciano Costa, MD2, Marguerite O'Hara, MPH3, Mary Slavcev, -4, Niodita Gupta-Werner, PhD5, Margaret Doyle, MSc6, Eric Ammann, PhD3, Sunny Patel, PhD3, Xiwu Lin, PhD5, Maria victoria Mateos, MD7.
1Johnson & Johnson, Beerse, Belgium, 2University of Alabama at Birmingham, Birmingham, AL, USA, 3Johnson & Johnson, Raritan, NJ, USA, 4Johnson & Johnson, Toronto, ON, Canada, 5Johnson & Johnson, Horsham, PA, USA, 6Johnson & Johnson, Dublin, Ireland, 7University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), Salamanca, Spain.
1Johnson & Johnson, Beerse, Belgium, 2University of Alabama at Birmingham, Birmingham, AL, USA, 3Johnson & Johnson, Raritan, NJ, USA, 4Johnson & Johnson, Toronto, ON, Canada, 5Johnson & Johnson, Horsham, PA, USA, 6Johnson & Johnson, Dublin, Ireland, 7University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), Salamanca, Spain.
OBJECTIVES: This study describes current standard-of-care treatment patterns and outcomes of patients with RRMM in early lines of therapy (LOT).
METHODS: Data were derived from the US Flatiron Health database for patients with an index date (initiation of RRMM treatment) between January 2016 and January 2025. Eligible patients had RRMM; received 1-3 prior LOT, including a proteasome inhibitor and lenalidomide (lenalidomide refractory if 1 prior LOT); had ECOG PS <3; were BCMA naïve; and could be anti-CD38 exposed but not refractory. Patient characteristics were summarized descriptively; time-to-event endpoints were summarized using Kaplan-Meier methods. Real-world progression-free survival (rwPFS) is reported to reflect the collection of disease progression data in real-world practice.
RESULTS: Overall, 3566 patients met the inclusion criteria: 1010 (28.3%) had 1 prior LOT, 2208 (61.9%) had 2 prior LOT, and 348 (9.8%) had 3 prior LOT; 1223 (34.3%) had high-risk cytogenetics; 2499 (70.1%) were daratumumab exposed; 869 (24.4%) had ISS stage I disease, 797 (22.3%) had stage II, 726 (20.4%) had stage III, and 1174 (32.9%) had unknown ISS stage. A high degree of variability in MM treatment regimens received was observed; daratumumab plus pomalidomide/dexamethasone (D-Pd) was the only regimen received by ≥10% of patients (422 [11.8%]). Median rwPFS was 8.0 months (95% CI, 7.5-8.6). In a univariate analysis, age ≥75 years, ISS stage III disease at diagnosis, and high-risk cytogenetics at baseline were strong predictors of poorer rwPFS. Median time to treatment discontinuation was 8.4 months (95% CI, 7.9-8.8), and median time to next treatment was 10.4 months (95% CI, 9.8-11.0).
CONCLUSIONS: There is a high unmet need to integrate more effective treatments earlier in this patient population, as reflected by short rwPFS and time to next treatment. The use of multiple regimens reflects the lack of standard treatment patterns for RRMM in real-word practice.
METHODS: Data were derived from the US Flatiron Health database for patients with an index date (initiation of RRMM treatment) between January 2016 and January 2025. Eligible patients had RRMM; received 1-3 prior LOT, including a proteasome inhibitor and lenalidomide (lenalidomide refractory if 1 prior LOT); had ECOG PS <3; were BCMA naïve; and could be anti-CD38 exposed but not refractory. Patient characteristics were summarized descriptively; time-to-event endpoints were summarized using Kaplan-Meier methods. Real-world progression-free survival (rwPFS) is reported to reflect the collection of disease progression data in real-world practice.
RESULTS: Overall, 3566 patients met the inclusion criteria: 1010 (28.3%) had 1 prior LOT, 2208 (61.9%) had 2 prior LOT, and 348 (9.8%) had 3 prior LOT; 1223 (34.3%) had high-risk cytogenetics; 2499 (70.1%) were daratumumab exposed; 869 (24.4%) had ISS stage I disease, 797 (22.3%) had stage II, 726 (20.4%) had stage III, and 1174 (32.9%) had unknown ISS stage. A high degree of variability in MM treatment regimens received was observed; daratumumab plus pomalidomide/dexamethasone (D-Pd) was the only regimen received by ≥10% of patients (422 [11.8%]). Median rwPFS was 8.0 months (95% CI, 7.5-8.6). In a univariate analysis, age ≥75 years, ISS stage III disease at diagnosis, and high-risk cytogenetics at baseline were strong predictors of poorer rwPFS. Median time to treatment discontinuation was 8.4 months (95% CI, 7.9-8.8), and median time to next treatment was 10.4 months (95% CI, 9.8-11.0).
CONCLUSIONS: There is a high unmet need to integrate more effective treatments earlier in this patient population, as reflected by short rwPFS and time to next treatment. The use of multiple regimens reflects the lack of standard treatment patterns for RRMM in real-word practice.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO204
Topic
Clinical Outcomes, Real World Data & Information Systems
Topic Subcategory
Clinician Reported Outcomes
Disease
Oncology