BURDEN of ILLNESS in PATIENTS with MULTIPLE MYELOMA (MM) WHO BECOME TRIPLE CLASS EXPOSED in the UK: RESULTS of A RETROSPECTIVE ANALYSIS from the RETINUE STUDY.
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All Authors
Parrish, C.
Smith, D.
Giles, H.
Venkatadasari, I.
Ahmed, R.
Karunanithi, K.
Kishore, B.
Choudhuri, S.
Ryan, P.
Al-Kaisi, F.
LTHT Author
Parrish, Christopher
Abdallah, Islam
Abdallah, Islam
LTHT Department
Oncology
Haematology
Doctors' Rotation
Haematology
Doctors' Rotation
Contributor Profession (Non Medical)
Publication Date
2025
Item Type
Conference Abstract
Language
Subject
Subject Headings
Abstract
Background Many retrospective and prospective observational studies have highlighted poor outcomes in patients refractory to a proteosome inhibitor (PI), an immunomodulator agent (IMiD) and an anti-CD38 monoclonal antibody (mAB). Limited data exist in the United Kingdom (UK) on these MM TCE (triple class exposed) patients with regards to their characteristics, treatment patterns and clinical outcomes. It is essential to generate real-world evidence to evaluate how sociodemographic and disease characteristics impact treatment patterns and clinical outcomes. Aims We aim to characterise MM TCE patients in the UK and estimate overall survival (OS) and time to next treatment (TTNT) from the start of TCE line of therapy (LoT) and the subsequent LoT post-TCE (index LoT), and evaluate how deprivation and timing of TCE impact OS and TTNT. Methods Retrospective cohort study of TCE MM patients was conducted with 18 UK hospitals via the West Midlands Research Consortium (WMRC). Eligible patients (>=18 years) were diagnosed with MM between Jan 2004 and Jul 2023 and had >=12 months follow-up post diagnosis (unless deceased). Sociodemographics, clinical characteristics and therapy lines were summarised descriptively. Deprivation was classified using the Index of Multiple Deprivation (IMD) based on postcode, with rank 1 representing the most deprived and rank 5 the least deprived areas in the UK. Chi-square tests evaluated associations between deprivation and timing of TCE and anti-CD38 LoTs. OS was analysed using the Kaplan-Meier (KM) method overall and by subgroups (deprivation and first anti-CD38 exposure LoT). TTNT analysis is ongoing. Results Analysis included 270 MM TCE patients with a median age at diagnosis of 64 (range: 29 - 84) and 58.9% male, who were TCE between Jun 2013 to Dec 2024. Deprivation (quintiles) at diagnosis were 1st (45.7%), 2nd (11.9%), 3rd (14.1%), 4th (15.2%), and 5th (13.0%). First anti-CD38 exposure was at 1st (6.7%), 2nd (16.3%), 3rd (10.4%), 4th (60.7%), 5th (3.7%), and >=6th (2.2%) LoT. Deprivation was associated with timing of anti-CD38 exposure (p=0.04). The LoT patients became TCE were 1st (6.7%), 2nd (13.0%), 3rd (13.3%), 4th (60.7%), 5th (4.1%), >=6th (2.2%). Mean follow-up time from start of the index LoT to earliest of death, lost to follow-up or data extraction initiation was 11.8 months (SD: 10.5). For OS analyses, 249 (92.2%) patients were included in the analysis from start of TCE LoT with a median of 31.7 months (95% CI 8.5 - 13.8); 85 (31.5%) patients were analysed from start of index LoT (TCR) with a median of 12.3 months (95% CI 10.5 - not achieved). No statistically significant differences between deprivation rank and anti-CD38 LoT were identified in stratified OS analyses from point of TCE or index LoTs. Summary/Conclusion In line with findings from other studies, including LocoMMotion, our results suggest an unmet need and short OS for TCE MM patients. Almost 58% of MM patients were from the two highest ranks of deprivation, with more than two-thirds achieving TCE at lines 4 and greater. There was an indication of an association between deprivation rank and the timing of anti-CD38 exposure, further analyses will examine how this impacts timing and affects clinical outcomes. No clear relationship was seen between OS and deprivation or anti-CD38 exposure LoT in both TCE and TCR cohorts, which may be due to small sample size and lack of OS data maturity.
Journal
HemaSphere