A Tale of Two Paradigms: Fixed Duration vs Continuous Therapy in Routine Clinical Practice: An INSIGHT MM Study Analysis

Researchers of a study presented at the 17th International Myeloma Workshop are aiming to characterize the longitudinal treatment pathway for patients with multiple myeloma (MM), while gaining an enhanced understanding of how long-term regimens are used.

In this study, which stands as the largest prospective, non-interventional, observation, MM study to- date (INSIGHT MM), adults from 15 countries across Europe, US, Latin America, and Asia are being enrolled and followed-up with for five or more years. The researchers collected data at baseline, and subsequently accumulated more data every three months. They seek to assess duration of therapy (DoT), reasons for discontinuation, and treatments with each regimen prescribed at first-, second-, or third-line therapy.

At the time of data discontinuation on Nov. 22, 2018, a total of 1,761 NDMM and 1,440 RRMM patients were enrolled, comprising 1,027 patients who had received second-line therapy, and 683 who had received third-line therapy. The regimens they evaluated included daratumumab-based therapy (lines 1/2/3, n=32/121/105), Ird (n=2/29/43), Kd (n=5/33/33), KRd (n=47/61/17), Rd (n=90/130/71), VCd (n=323/57/19), Vd (n=102/48/29), VMP (n=53/8/3), VRd (n=321/36/8), and VTd (n=200/25/4).

The results showed that of 185 patients who discontinued treatment, 35% had completed planned DoT, 26% had stopped treatment due to experiencing adverse events and 14% had discontinued treatment after suffering a relapse. Among 72 patients who discontinued second-line treatment, 31% had stopped treatment due to relapse, 28% stopped due to adverse events, while 17% had completed planned DoT. Also, among third-line treatment patients, 52 discontinued treatment, and relapse was the common treatment, observed in 37% of patients, followed by 25% stopping due to adverse events, and 13% completing planned DoT.

“In this interim analysis the most common reason for stopping 1stline therapy was reaching the end of planned therapy; reasons for discontinuation change as patients move through lines of therapy,” the researchers wrote in conclusion. “Analyses by specific regimens and transplant status will be presented to determine impact on DoT and reasons for discontinuation.”

Weisel K, et al. A Tale of Two Paradigms: Fixed Duration vs Continuous Therapy in Routine Clinical Practice: An INSIGHT MM Study Analysis of Duration of Therapy. Presented at the 17th International Myeloma Workshop; September 12-15, 2019; Boston, MA.