Disease Outcomes Among Real-World Patients With Relapsed and Triple-Class Refractory Multiple Myeloma

Findings from a Multicenter Retrospective Cohort Real-World Study

Real-world findings published in Blood Cancer Journal showed that disease outcomes are unfavorable among patients with relapsed and triple-class refractory (TCR) multiple myeloma (MM), including patients refractory to a proteasome inhibitor, immunomodulatory drug, and anti-CD38 monoclonal antibody (mAb), after receiving standard-of-care (SoC) treatment. These results support the need to develop novel therapeutic practices to more effectively treat this patient population. 

Dr A Visram, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, and coauthors noted that despite the advancements in research on the efficacy of anti-B-cell maturation antigen (BCMA) therapies for MM, “Outcomes of real-world patients with refractory MM treated with standard-of-care therapies are needed to serve as a benchmark and contextualize improvements in health outcomes with these emerging therapies.” 

In this multicenter retrospective cohort real-world study, a total of 663 patients with MM who were refractory to an anti-CD38 mAb-based index regimen (after 4 weeks of treatment or more) and were then treated with SoC regimens were included from the Canadian Myeloma Research Group Database. Patients with TCR disease (n = 199), including those refractory to a proteasome inhibitor, immunomodulatory drug, and anti-CD38 mAb, were included in a distinct cohort. Of the total patients, 346 were treated with SoC regimens and included in this trial, with a median age of 67.9 years and a median of 3 prior lines of therapy. 

Results indicated that the median progression-free survival from the start of subsequent therapy was 4.6 months, and the median overall survival from the start of subsequent therapy was 13.3 months. Among patients with TCR disease, the median progression-free survival was 4.4 months and the median overall survival was 10.5 months. 

Based on these results, Dr Visram and the study authors concluded, “Real-world patients with relapsed MM, particularly those with TCR disease, have dismal outcomes.”

“There remains an urgent unmet need for the development of and access to effective therapeutics for these patients,” they added. 

Source: 

Visram A, De La Torre A, White D, et al. Real world data on outcomes of anti-CD38 antibody treated, including triple class refractory, patients with multiple myeloma: a multi-institutional report from the Canadian Myeloma Research Group (CMRG) Database. Blood Cancer J. Published online: December 8, 2023. doi: 10.1038/s41408-023-00946-z