OBJECTIVES: The management of multiple myeloma (MM) has changed considerably yet real-world data on treatment patterns are scarce. The PREMIERE study explored patient characteristics and treatment patterns in patients treated for a first episode of Relapse/Refractory Multiple Myeloma (RRMM) in Spain.

METHODS: Retrospective cohort chart review study of patients treated for RRMM over 3 years in 31 hematology centers in Spain. Patients ≥18 years with ≥1 prior line of therapy (LOT) for MM, starting a LOT (index therapy, LOT1) due to relapsing or refractory disease were followed up to the earlier of loss to follow-up, enrollment into a clinical trial, end of follow-up, or death. Patient characteristics at index and treatment patterns are described.

RESULTS: A total of 284 patients, 53.9% male, with a mean age of 68 years at index were followed for a median 20.1 (Q1-Q3=7.9-34.1) months. Average disease duration at index was 2.5 years, 72.3% patients with relapsed disease, and 83.1% with only one LOT before index. Prior treatments included: corticosteroids (97.5%), chemotherapy (70.4%, mainly with melphalan), proteasome inhibitors (PIs) (75.7%, mainly bortezomib), immunomodulators (9.2%, all lenalidomide), stem cell transplant (29.6%) and radiotherapy (16.2%). LOT1 treatments were: immunomodulators (42.3%), PIs (17.3%), chemotherapies (14.4%), and combinations (24.6%). The maximum number of LOTs after index was seven: 284 (100%) LOT1, 56.7% LOT2, 29.9% LOT3, 13.4% LOT4. Lenalidomide + dexamethasone was the most frequent treatment regimen in LOTs 1 (38.4%) and 2 (25.5%), followed by bortezomib + dexamethasone (16.6% and 14.3%), whereas chemotherapy regimens were increasingly used in LOT3 (30.6%) and beyond (>30% in subsequent LOTs), progressively replacing all other treatment strategies.

CONCLUSIONS: This study provides data of recent treatment patterns in RRMM, contributing to a better understanding of the added value of new treatments.