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- Title
Factors associated with second-line triplet therapy in routine care in relapsed/refractory multiple myeloma.
- Authors
Hari, P.; Romanus, D.; Henk, H. J.; Becker, L. K.; Noga, S. J.; Morrison, V. A.
- Abstract
What is known and objective Second-line therapy ( SLT) trials in relapsed/refractory multiple myeloma ( RRMM) report superior outcomes with triplet combinations. We sought to determine factors associated with triplet SLT in routine practice. Methods A retrospective cohort with claims for MM between 01/01/2008 and 03/31/2015 was grouped by 1-2 ('doublet') or 3+ ('triplet') agent therapy. Charlson comorbidity index ( CCI) and disability status; CRAB symptoms (hypercalcaemia, renal/bone disease, anaemia); and relapse risk were determined. Results Among 623 patients, the triplet group (n=146 [23%]) was younger (65.2 vs 69.8 years) and more likely to have high-risk relapse (67% vs 50%), CRAB symptoms (94.5% vs 81.1%), triplet first-line treatment (75% vs 51%) and frontline stem cell transplant (38% vs 20%) ( P<0.001 for all). In multivariate analyses, CRAB symptoms ( OR: 3.22, 95% CI: 1.47, 7.10), high-risk relapse ( OR: 1.71, 95% CI: 1.12, 2.62) and prior triplet therapy ( OR: 2.16, 95% CI: 1.38, 3.40), but neither CCI nor disability, were associated with triplet SLT. A trend towards triplets among younger patients (<65 vs >75 years, OR: 1.73, 95% CI: 0.99, 3.04) was observed. What is new and conclusion The majority of patients did not receive triplet regimens. Treatment selection with triplet therapy for RRMM should carefully consider comorbidities and patient-specific characteristics.
- Subjects
ANTINEOPLASTIC agents; AGE distribution; CONFIDENCE intervals; DRUG prescribing; LONGITUDINAL method; MULTIPLE myeloma; MULTIVARIATE analysis; PROBABILITY theory; COMORBIDITY; DISEASE relapse; PHYSICIAN practice patterns; SAMPLE size (Statistics); TREATMENT effectiveness; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio
- Publication
Journal of Clinical Pharmacy & Therapeutics, 2018, Vol 43, Issue 1, p45
- ISSN
0269-4727
- Publication type
Article
- DOI
10.1111/jcpt.12606