Multiple Myeloma Treatment in Real-world Clinical Practice: Results of a Prospective, Multinational, Noninterventional Study

Abstract Background This prospective, multinational, non-interventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and methods Adult patients initiating any new MM therapy between October 2010–2012 were eligible. A multi-staged patient/site recruitment model was applied to minimise selection bias; enrolment was stratified by country, region, and practice type. Patients' medical/disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results 2358 patients were enrolled, of whom 775 received and 1583 did not receive stem-cell transplant (SCT) at any time during treatment; 49%/21%/14%/15% and 57%/20%/12%/10% of patients in the SCT and non-SCT groups, respectively, were enrolled at line 1/2/3/4+ of treatment. In the SCT/non-SCT groups, 45%/54% of patients received bortezomib-based therapy without thalidomide/ lenalidomide, 12%/18% received thalidomide/ lenalidomide-based therapy without bortezomib, and 30%/4% received bortezomibplus thalidomide/ lenalidomide-based therapy as frontline treatment. The respective proportions in SCT/non-SCT patients in line 2 were 45%/37%, 30%/37%, and 12%/3%, in line 3 were 33%/27%, 35%/32%, and 8%/2%, and in line 4+ were 27%/27%, 27%/23%, and 6%/4%. In SCT/non-SCT patients, overall response rates were 86-97%/64-85% in line 1, 74-78%/59-68% in line 2, 55-83%/48-60% in line 3, and 49-65%/36-45% in line 4 for regimens including bortezomiband/or thalidomide/ lenalidomide. Conclusion Our prospective study reveals huge diversity in treatments used to manage MM in real-life practice, linked to factors such as novel-agent accessibility and evolving treatment recommendations, and provides insight into associated clinical benefits.