There is significant variation in how European practices treat patients with multiple myeloma, according to a cross-sectional study published in the British Journal of Haematology.
For the study, researchers conducted an observation chart review of 435 European physicians that included treatment patterns for 7635 patients with multiple myeloma. The physicians included in the analysis completed questionnaires for every patient they saw during a 2-4 week observation period, regardless of their treatment status.
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Overall, they found that 47% of patients were undergoing anti-tumor drug treatment, 42% had previously received at least 1 line of treatment, and 12% had never received anti-tumor drug treatment.
When the researchers reviewed data from patients treated only by oncologists, onco-hematologists, or internists, they found that 95% received, or were expected to receive, at least 1 line of anti-tumor drug treatment. Of these patients, 61% received at least 2 lines of therapy while 38% received at least 3 lines of therapy.
Except in the United Kingdom, the most commonly used induction therapy regiments included bortezomib (48%). Lenalidomide was the drug most commonly used first-line maintenance therapy (45%), and was used in 60% and 52% of patients as a second- or third-line agent, respectively. Additionally, bortezomib retreatment was prescribed in 47% of patients who received it as a first-line therapy. Treatment patterns also continued to grow more diverse with subsequent lines of therapy.
Researchers concluded that while there are some broad similarities in multiple myeloma treatment across Europe, some notable differences in the agents used still exist.
“These results show how heterogeneous treatments for relapsed patients previously treated with a proteasome inhibitor and an immunomodulatory drug already are, and reflect upon how the new treatment options arriving in this setting are likely to continue to affect the way multiple myeloma is managed,” added study author Marc Raab, MD, Heidelberg University Hospital and German Cancer Research Centre in Germany.
