title: Multiple myeloma: patient outcomes in real-world practice.
abstract: With increasing number of therapies available for the treatment of multiple myeloma, it is timely to examine the course of patients' journeys. We investigated patient characteristics, treatment durations and outcomes, and symptom burden across the treatment pathway in Belgium, France, Germany, Italy, Spain, Switzerland and the UK. In total, 435 physicians retrospectively reviewed 4997 patient charts. Profiles of patients diagnosed with multiple myeloma during the last 12 months were similar across countries; bone pain was the most common presentation. Median duration of first-line therapy was 6 months, followed by a median treatment-free interval of 10 months; both these decreased with increasing lines of therapy, as did time to progression. Depth of response, as assessed by the treating physician, also decreased with each additional line of therapy: 74% of patients achieved at least a very good partial response at first line, compared with only 11% at fifth line. Deeper responses were associated with longer time to progression, although these were physician-judged. Toxicities and co-morbidities increased with later treatment lines, and were more likely to have led to discontinuation of treatment. These real-world data provide an insight into patient outcomes and treatment decisions being made in clinical practice.
authors.affiliation: Department of Haematology, University College London, London, UK. kwee.yong@ucl.ac.uk.
authors.forename: Kwee
authors.initials: K
authors.lastname: Yong
authors.affiliation: Department of Haematology, UZ Leuven, Leuven, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Delforge
authors.affiliation: Department of Oncology and Hematology, Kantonsspital St Gallen, St Gallen, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Driessen
authors.affiliation: Kantar Health, Montrouge, France.
authors.forename: Leah
authors.initials: L
authors.lastname: Fink
authors.affiliation: Kantar Health, Montrouge, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Flinois
authors.affiliation: Global Health Economics, Amgen (Europe) GmbH, Zug, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Gonzalez-McQuire
authors.affiliation: Global Health Economics, Amgen (Europe) GmbH, Zug, Switzerland.
authors.forename: Reza
authors.initials: R
authors.lastname: Safaei
authors.affiliation: Centre Hospitalier Lyon-Sud, Lyon, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Karlin
authors.affiliation: Department of Hematology, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: Maria-Victoria
authors.initials: MV
authors.lastname: Mateos
authors.affiliation: Department of Internal Medicine, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Marc S
authors.identifier: http://orcid.org/0000-0003-4181-6922
authors.initials: MS
authors.lastname: Raab
authors.affiliation: Value Access & Policy, Amgen (Europe) GmbH, Zug, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Schoen
authors.affiliation: 'Seràgnoli' Institute of Hematology and Medical Oncology, Bologna University School of Medicine, Bologna, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D019468:Disease Management; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D010641:Phenotype; D010820:Physicians; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: depth of response; duration of therapy; multiple myeloma; patient chart review; real-world practice