Heterogeneity of Second-Line Treatment for Patients With Multiple Myeloma in the Connect MM Registry (2010-2016)

Sundar Jagannath, Rafat Abonour, Brian G.M. Durie, Cristina Gasparetto, James W. Hardin, Mohit Narang, Howard R. Terebelo, Kathleen Toomey, Lynne Wagner, Shankar Srinivasan, Amani Kitali, Lihua Yue, E. Dawn Flick, Amit Agarwal, Robert M. Rifkin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Connect MM is a large prospective observational US-based disease registry that was used to evaluate second-line treatment patterns in patients with relapsed or refractory multiple myeloma during a 5-year period, from 2010 to 2016. Treatment uptake was found to coincide with clinical milestones (ie, regulatory approvals, clinical study results), with growing preference for newer agents and triplet combinations over time. 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.

Original languageEnglish (US)
JournalClinical Lymphoma, Myeloma and Leukemia
DOIs
StateAccepted/In press - Jan 1 2018

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Multiple Myeloma
Registries
Therapeutics
Practice Management
Peripheral Nervous System Diseases
Dexamethasone
Publications
Randomized Controlled Trials
Color
Physicians
Kidney

Keywords

  • Community
  • Real-world
  • Refractory
  • Relapsed
  • Therapies

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Heterogeneity of Second-Line Treatment for Patients With Multiple Myeloma in the Connect MM Registry (2010-2016). / Jagannath, Sundar; Abonour, Rafat; Durie, Brian G.M.; Gasparetto, Cristina; Hardin, James W.; Narang, Mohit; Terebelo, Howard R.; Toomey, Kathleen; Wagner, Lynne; Srinivasan, Shankar; Kitali, Amani; Yue, Lihua; Flick, E. Dawn; Agarwal, Amit; Rifkin, Robert M.

In: Clinical Lymphoma, Myeloma and Leukemia, 01.01.2018.

Research output: Contribution to journalArticle

Jagannath, S, Abonour, R, Durie, BGM, Gasparetto, C, Hardin, JW, Narang, M, Terebelo, HR, Toomey, K, Wagner, L, Srinivasan, S, Kitali, A, Yue, L, Flick, ED, Agarwal, A & Rifkin, RM 2018, 'Heterogeneity of Second-Line Treatment for Patients With Multiple Myeloma in the Connect MM Registry (2010-2016)', Clinical Lymphoma, Myeloma and Leukemia. https://doi.org/10.1016/j.clml.2018.04.007
Jagannath, Sundar ; Abonour, Rafat ; Durie, Brian G.M. ; Gasparetto, Cristina ; Hardin, James W. ; Narang, Mohit ; Terebelo, Howard R. ; Toomey, Kathleen ; Wagner, Lynne ; Srinivasan, Shankar ; Kitali, Amani ; Yue, Lihua ; Flick, E. Dawn ; Agarwal, Amit ; Rifkin, Robert M. / Heterogeneity of Second-Line Treatment for Patients With Multiple Myeloma in the Connect MM Registry (2010-2016). In: Clinical Lymphoma, Myeloma and Leukemia. 2018.
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abstract = "Connect MM is a large prospective observational US-based disease registry that was used to evaluate second-line treatment patterns in patients with relapsed or refractory multiple myeloma during a 5-year period, from 2010 to 2016. Treatment uptake was found to coincide with clinical milestones (ie, regulatory approvals, clinical study results), with growing preference for newer agents and triplet combinations over time. 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.",
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AU - Abonour, Rafat

AU - Durie, Brian G.M.

AU - Gasparetto, Cristina

AU - Hardin, James W.

AU - Narang, Mohit

AU - Terebelo, Howard R.

AU - Toomey, Kathleen

AU - Wagner, Lynne

AU - Srinivasan, Shankar

AU - Kitali, Amani

AU - Yue, Lihua

AU - Flick, E. Dawn

AU - Agarwal, Amit

AU - Rifkin, Robert M.

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N2 - Connect MM is a large prospective observational US-based disease registry that was used to evaluate second-line treatment patterns in patients with relapsed or refractory multiple myeloma during a 5-year period, from 2010 to 2016. Treatment uptake was found to coincide with clinical milestones (ie, regulatory approvals, clinical study results), with growing preference for newer agents and triplet combinations over time. 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.

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