OBJECTIVES:

To describe the characteristics of, and treatment outcomes in patients with specific profiles in the real-world NDMM setting.

METHODS:

The data presented were derived from a 2016 retrospective chart analysis of 813 patients whose disease had progressed after first line (1L). Patient profiles were constructed based on stem-cell transplant (SCT) eligibility, agents used in 1L, and time to progression (TTP). All analyses were descriptive.

RESULTS:

Of the 813 patients, 31% received a SCT and a bortezomib-based regimen (V). Of the 496 (61%) patients who did not receive a SCT, 71% received V, 22% received immunomodulator-based regimens (IMiD) and 7% received other regimens. Patients were then stratified by TTP (early [< 12 months] vs late [≥ 12months]). Five profiles were identified accounting for 88% of the patients included. Profile 1a (P1a): SCT, V and late progression (26%); P1b: SCT, V and early progression (6%); P2a: non-SCT, V and late progression (26%); P2b: non-SCT, V and early progression (18%), and P3: non-SCT and IMiD (13%). The median TPP and complete response rates for profiles P1a, P1b, P2a, P2b and P3 were: 33.5 months and 51%; 10 months and 16%; 24 months and 26%; 6 months and 5%; and 17 months and 24%, respectively. The proportion of patients with revised International Staging System stage III disease and the proportion of patients assessed for cytogenetic abnormalities with high-risk cytogenetics was higher in profile P1b than P1a (42% vs 22% and 25% vs 15%, respectively) and in profile P2b than P2a (46% vs 35% and 31% vs 19%, respectively). These differences may explain the differences observed in treatment outcomes.

CONCLUSIONS:

Achieving a prolonged TPP for all patients with NDMM continues to be a challenge. Understanding why patients progress early may inform subsequent treatment decisions and improve outcomes for patients with MM.