OBJECTIVES: Data from real-world European settings describing treatment patterns and outcomes in relapsed/refractory multiple myeloma (RRMM) are limited. This study helps address this knowledge gap using a brief physician survey.
METHODS: Sixty-one physicians treating RRMM were surveyed (November 2014) in France (n=21), Germany (n=20), and the United Kingdom (UK) (n=20). The survey collected physicians’ opinions on typical treatment patterns and outcomes of RRMM patients in the relapse/refractory setting (following disease progression during/after first-line therapy). Analyses were descriptive.
RESULTS: Sixty percent of physicians in France and the UK were haematologists, versus 10% in Germany (where 80% were onco-haematologists). The proportion of patients with high-risk disease based on ISS stage and cytogenetics was 18%-24% across countries. Bortezomib/thalidomide/dexamethasone was the most common induction regimen (42%) for stem cell transplant (SCT)-eligible patients in France, but was unused in Germany and less commonly prescribed in the UK (17%); bortezomib/cyclophosphamide/dexamethasone was the reported induction therapy for 28% of SCT-eligible patients in all countries. Regardless of SCT status, lenalidomide/dexamethasone was the predominant second-line treatment (37%-48%) reported in France and Germany; in the UK, second-/later-line regimens were more varied, with both lenalidomide- and bortezomib-based regimens being reported as common. Second-/later-line therapy duration was generally short, particularly in the UK where 75% of physicians reported a <6-month duration. Disease progression was the top reason for second/later-line discontinuation; other common reasons included toxicity and completion of planned therapy course. For high-risk patients, >75% of physicians reported median survival of <1 year from first relapse.
CONCLUSIONS: The proportion of RRMM patients with high-risk disease in real-world settings (18%-24%) may exceed that reported in clinical trials (10%-15%). Second-/later-line therapy duration is typically short (<6 months). Survival prospects for RRMM patients remain limited, particularly for high-risk patients. Patient-level studies are needed to better characterize the unmet needs in RRMM signaled by our findings.
