Multiple Myeloma Treatment Patterns Varied By Geographic Region

Differences in real-world treatment patterns and clinical outcomes exist among patients with multiple myeloma (MM) treated in different geographical regions, according to a systematic literature review presented at the European Hematology Association 2021 Virtual Annual Meeting

“Understanding these differences in real-world clinical practice and their outcomes will help inform clinicians of the optimal use of available treatments, identify unmet needs, and help further improve long-term outcomes for patients,” wrote the study author Elena Zamagni, University of Bologna, Bologna, Italy, and colleagues.

To examine these patterns, the researchers searched literature from January 2010 to November 2020 for English-language publications on the efficacy and safety of therapies for patients with newly diagnosed MM (NDMM) and relapsed or refractory MM (RRMM). Relevant conferences in 2019 and 2020 were also searched.

They identified 472 relevant publications, the majority of which were published after 2016. Forty-seven percent of patients in the studies had RRMM, 41% included patients with NDMM and 12% had a mix of MM populations.

Of the 472 publications, 149 included data from multicenter/claims database/registry studies that involved at least 50 patients; 28 of the 149 reported median overall survival and 23 reported median progression-free survival.

The researchers noted several differences in treatment patterns and outcomes between geographical regions. For example, for NDMM bortezomib-based regimens were more common in Europe and Asia. The most common of these were bortezomib plus dexamethasone, bortezomib-cyclophosphamide-dexamethasone, bortezomib-melphalan-prednisone, and bortezomib-thalidomide-dexamethasone.

In the United States, in contrast, lenalidomide plus dexamethasone-based regimens and bortezomib-based regimens were equally described.

For patients with RRMM, dexamethasone and dexamethasone-based triplets were the most commonly used regimens across all three regions.

Zamagni also noted that reported survival outcomes also differed widely between different studies, “possibly reflecting differences in regimens used and patient management”.