Sundar Jagannath1, Rafat Abonour2, Brian G M Durie3, Cristina Gasparetto4, James W Hardin5, Mohit Narang6, Howard R Terebelo7, Kathleen Toomey8, Lynne Wagner9, Shankar Srinivasan10, Amani Kitali10, Lihua Yue10, E Dawn Flick10, Amit Agarwal10, Robert M Rifkin11. 1. Mount Sinai Hospital, New York, NY. Electronic address: sundar.jagannath@mssm.edu. 2. Indiana University Simon Cancer Center, Indianapolis, IN. 3. Cedars Sinai Samuel Oschin Cancer Center, Los Angeles, CA. 4. Division of Cellular Therapy, Duke University Medical Center, Durham, NC. 5. University of South Carolina, Columbia, SC. 6. US Oncology Research, Maryland Oncology Hematology, Columbia, MD. 7. Providence Cancer Institute, Southfield, MI. 8. Steeplechase Cancer Center, Somerville, NJ. 9. Wake Forest University School of Medicine, Winston-Salem, NC. 10. Celgene Corporation, Summit, NJ. 11. US Oncology Research, Rocky Mountain Cancer Centers, Denver, CO.
Abstract
BACKGROUND: The treatment landscape for multiple myeloma (MM) has undergone recent changes with the regulatory approval of several new therapies indicated for second- and later-line disease. Using data from Connect MM, the largest multisite, primarily community-based, prospective, observational registry of MM patients in the United States, selection of second-line treatments was evaluated during a 5-year period from 2010 to 2016. PATIENTS AND METHODS: Eligible patients were aged ≥ 18 years, had newly diagnosed MM ≤ 2 months before study entry, and were followed for up to 8 years. Patients who received ≥ 2 lines of therapy were analyzed. "Tepee" plots of stacked area graphs differentiated treatments by color to allow visualization of second-line treatment trends in MM patients. RESULTS: As of February 2017, 855 of 2897 treated patients had progressed to second-line treatment. Treatment selection was heterogeneous; shifting patterns of treatment choices coincided with the approval status of newer agents. The most common treatment regimens in the early part of the decade were lenalidomide and/or bortezomib, with or without dexamethasone, with increasing use of newer agents (carfilzomib, pomalidomide, daratumumab, and elotuzumab) and triplet combinations over time. The influence of the baseline patient characteristics of age, history of diabetes, peripheral neuropathy, and renal function on treatment choice was also examined. CONCLUSION: These findings indicate that community physicians are current in their MM management practices, with uptake of new drugs and acquaintance with results of randomized clinical trials using combinations almost concurrent with their regulatory approval and publication.
BACKGROUND: The treatment landscape for multiple myeloma (MM) has undergone recent changes with the regulatory approval of several new therapies indicated for second- and later-line disease. Using data from Connect MM, the largest multisite, primarily community-based, prospective, observational registry of MM patients in the United States, selection of second-line treatments was evaluated during a 5-year period from 2010 to 2016. PATIENTS AND METHODS: Eligible patients were aged ≥ 18 years, had newly diagnosed MM ≤ 2 months before study entry, and were followed for up to 8 years. Patients who received ≥ 2 lines of therapy were analyzed. "Tepee" plots of stacked area graphs differentiated treatments by color to allow visualization of second-line treatment trends in MM patients. RESULTS: As of February 2017, 855 of 2897 treated patients had progressed to second-line treatment. Treatment selection was heterogeneous; shifting patterns of treatment choices coincided with the approval status of newer agents. The most common treatment regimens in the early part of the decade were lenalidomide and/or bortezomib, with or without dexamethasone, with increasing use of newer agents (carfilzomib, pomalidomide, daratumumab, and elotuzumab) and triplet combinations over time. The influence of the baseline patient characteristics of age, history of diabetes, peripheral neuropathy, and renal function on treatment choice was also examined. CONCLUSION: These findings indicate that community physicians are current in their MM management practices, with uptake of new drugs and acquaintance with results of randomized clinical trials using combinations almost concurrent with their regulatory approval and publication.
Authors: Evangelos Terpos; Karthik Ramasamy; Nadjoua Maouche; Jiri Minarik; Ioannis Ntanasis-Stathopoulos; Eirini Katodritou; Matthew W Jenner; Hana Plonkova; Maria Gavriatopoulou; Grant D Vallance; Tomas Pika; Maria Kotsopoulou; Jaimal Kothari; Tomas Jelinek; Efstathios Kastritis; Robin Aitchison; Meletios A Dimopoulos; Athanasios Zomas; Roman Hajek Journal: Ann Hematol Date: 2020-04-01 Impact factor: 3.673
Authors: Habte Yimer; Jason Melear; Edward Faber; William I Bensinger; John M Burke; Mohit Narang; Don Stevens; Sriya Gunawardena; Yana Lutska; Keqin Qi; Jon Ukropec; Ming Qi; Thomas S Lin; Robert M Rifkin Journal: Br J Haematol Date: 2019-03-03 Impact factor: 6.998
Authors: Sikander Ailawadhi; Sundar Jagannath; Mohit Narang; Robert M Rifkin; Howard R Terebelo; Kathleen Toomey; Brian G M Durie; James W Hardin; Cristina J Gasparetto; Lynne Wagner; James L Omel; Vivek Kumar; Lihua Yue; Amani Kitali; Amit Agarwal; Rafat Abonour Journal: Cancer Med Date: 2019-11-07 Impact factor: 4.452
Authors: Rafat Abonour; Robert M Rifkin; Cristina Gasparetto; Kathleen Toomey; Brian G M Durie; James W Hardin; Howard R Terebelo; Sundar Jagannath; Mohit Narang; Sikander Ailawadhi; James L Omel; Hans C Lee; Shankar Srinivasan; Amani Kitali; Amit Agarwal; Lynne Wagner Journal: Br J Haematol Date: 2020-10-29 Impact factor: 6.998