OBJECTIVES

To describe real-world use of carfilzomib (K), bortezomib (V), lenalidomide (R), pomalidomide (P), ixazomib (I), daratumumab (D) and elotuzumab (E) in relapsed/refractory (RR) multiple myeloma (MM) patients in Germany.

METHODS

This retrospective analysis was based on 2015 to February 2019 LRx database, which includes nationwide data on 80% of prescriptions (full product information and prescription data) reimbursed by statutory health insurance funds in Germany. We analyzed demographic and treatment characteristics by regimen and line (2 and 3L+) in mutually exclusive categories. A validated algorithm was used to determine treatment regimens and end of treatment line (Palmaro 2017).

RESULTS

This analysis included 4,533 RRMM patients, with most recent regimen in 2L 3,537 and 996 in 3L+. 2L patients were treated with V 31% (triplet 22%, non-triplet 9%), R non-triplet 21% and K 19% (non-triplet 14%, triplet 5%), D 16% (non-triplets 8%, triplets 8%), P 6%, E and I 3-4% each. Where known, previous treatment included V (62%), R non-triplet (28%) or regimens based on melphalan or cytostatic drugs (10%). 3L+ patients were treated with D 35% (non-triplet 17%, triplet 18%), K 22% (non-triplet 12%, K triplet 10%), V, P and R regimens 8-12%. Previous treatment included V (24%), D (17%), R (16%), K (25%), P, E, and I (2-8%). In 2L, mean age ranged from 65-74 years. Older patients and those with higher estimated Charlson comorbidity index (CCI > 1), more often received regimens containing V and/or R and non-triplet regimens In 3+L, more patients with higher estimated CCIs (>1) more often received treatment containing D, K, I, E or P.

CONCLUSIONS

This real-world database analysis shows that majority of patients in 2L are treated with older R or V-based regimens. This reflects lower use of more potent novel and combination therapies than expected. Trends by year will be investigated.