Presentation (CTI)

OBJECTIVES: Time toxicity, defined as the time patients spend receiving treatment or interacting with the healthcare system, is increasingly recognized as a patient-centered outcome. Various methods are used and there is an ongoing discussion to include these points into treatment decisions. In recent years treatment complexity creates a substantial time burden, yet systematic analyses are lacking.
METHODS: To test a model in the German healthcare system, we collected information based on official sources like SmPC to estimate treatment-related time burden across regimens in ≥4th-line RRMM. Inputs included hospital and outpatient visits, administration and patients travel time. Results were standardized to a 12-week treatment duration and expressed as total hours and healthcare contacts.
RESULTS: Time toxicity is mainly driven by visit frequency and treatment duration. The highest number of visits (12-14) are required for bispecific antibodies, followed by Elotuzumab and Daratumumab containing regimens with 9-10 visits. Exemption here is Carfilzomib with the highest number of visits (18). The lowest number (3 visits/quarter) is observed for Selinexor and Melflufen. Number of visits also influences the total time toxicity with the highest burden for bi-specific antibodies; 222,2 hours for Teclistamab and Talquetamab, followed by Elranatamab (168,6 hours). The lowest burden is seen in Selinexor with 1,5 hours followed by Melflufen with 3,8 hours. The analysis further highlights a substantially influence of the combination partners. Belantamab combined with Pomalidomide appears compatible with orally pomalidomide (7,0 hours), whereas time toxicity is pronounced in combination with weekly subcutaneous bortezomib (16,0 hours).
CONCLUSIONS: Time toxicity for RRMM treatment options represents an important, yet underutilized, dimension for patient-centered decision-making. This model provides a structured framework to quantify treatment-related time burden and may complement clinical and economic outcomes. Across advanced MM regimens, time burden varies widely from 222,2 hours to 1,5 hours per quarter.