Front-line treatment patterns in multiple myeloma: An analysis of U.S.-based electronic health records from 2011 to 2019.
Front-line treatment patterns in multiple myeloma: An analysis of U.S.-based electronic health records from 2011 to 2019.
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DOI：
10.1002/cam4.4137
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发表时间：
2021-09
期刊：
影响因子：
4
通讯作者：
Hong WJ
中科院分区：
文献类型：
--
作者：
Kumar S;Williamson M;Ogbu U;Surinach A;Arndorfer S;Hong WJ
多发性骨髓瘤（MM）的治疗方案发展迅速，但在目前的实践中，如何将新药物纳入治疗决策尚不清楚。本研究检查了美国医生治疗新诊断MM的处方趋势和治疗结局。2011年1月1日至2020年1月31日期间，6271例确诊为MM并接受初始治疗的成人患者的电子健康记录数据来自Flatiron Health电子健康记录去识别数据库。评估了治疗方案中包含的药物数量/类型、至下次治疗的时间（TTNT）和总生存期（OS）。通过国际分期系统（ISS）诊断时的疾病分期、干细胞移植资格和时间以及实践类型对亚组进行分析。探索性预后模型评价了基线协变量与至事件发生时间结局之间的相关性。接受三联疗法的患者比例从2011年（36%）增加到2019年（72%），而接受初始单药治疗或双联疗法的患者比例减少。总体而言，最流行的三联方案包括免疫调节药物（IMiD）、蛋白酶体抑制剂和类固醇。从2017年到2019年，ISS I期患者从一线到二线的中位TTNT长于II/III期患者，接受含IMiD的双联或三联治疗的患者也长于其他联合治疗的患者。总体中位OS为56个月，从2011年到2014年有所增加，之后尚未达到中位OS。年龄、ISS分期和高危状态是OS和TTNT的预后因素，而性别、执业类型和ECOG状态仅是OS的预后因素。这份手稿是一项基于代表标准真实的世界骨髓瘤治疗方法的美国健康记录的回顾性研究。该研究确定了新诊断骨髓瘤的治疗方法的逐渐转变，三联方案的使用越来越多，以及当前方法的生存结局改善。
Multiple myeloma (MM) treatment options have evolved rapidly, but how new agents are incorporated into treatment decisions in current practice is not well understood. This study examined prescribing trends of physicians treating newly diagnosed MM and treatment outcomes in the United States. Electronic health record data from 6271 adult patients diagnosed with MM and receiving initial treatment between 1 January 2011 and 31 January 2020 were derived from the Flatiron Health electronic‐health record de‐identified database. The number/types of agents included in therapy regimens, time to next treatment (TTNT), and overall survival (OS) were assessed. Subgroups were analyzed by the International Staging System (ISS) disease stage at diagnosis, stem cell transplant eligibility and timing, and practice type. Exploratory prognostic models evaluated the association between baseline covariates and time‐to‐event outcomes. The proportion of patients receiving triplet therapies increased from 2011 (36%) to 2019 (72%) as those receiving initial monotherapy or doublet therapy decreased. Overall, the most prevalent triplet regimen consisted of an immunomodulatory drug (IMiD), a proteasome inhibitor, and a steroid. From 2017 to 2019, median TTNT from front‐line to second‐line was longer in patients with ISS stage I versus stages II/III, and in those receiving IMiD‐containing doublet or triplet therapies versus other combinations. Overall median OS was 56 months and increased from 2011 to 2014, after which median OS was not yet reached. Age, ISS stage, and high‐risk status were prognostic for both OS and TTNT, while sex, practice type, and ECOG status were prognostic for OS only. This manuscript is a retrospective study based on US health records representative of the standard real world approach to treatment of myeloma. The study identifies the gradual shift in the treatment approaches to newly diagnosed myeloma, with increasing use of triplet regimens, and the improved survival outcomes with the current approaches.
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影响因子：
11.4
作者：
Kumar SK;Lee JH;Lahuerta JJ;Morgan G;Richardson PG;Crowley J;Haessler J;Feather J;Hoering A;Moreau P;LeLeu X;Hulin C;Klein SK;Sonneveld P;Siegel D;Bladé J;Goldschmidt H;Jagannath S;Miguel JS;Orlowski R;Palumbo A;Sezer O;Rajkumar SV;Durie BG;International Myeloma Working Group
通讯作者：
International Myeloma Working Group
影响因子：
6.5
作者：
Yong K;Delforge M;Driessen C;Fink L;Flinois A;Gonzalez-McQuire S;Safaei R;Karlin L;Mateos MV;Raab MS;Schoen P;Cavo M
通讯作者：
Cavo M
影响因子：
12.8
作者：
Paquin, Ashley R.;Kumar, Shaji K.;Rajkumar, S. Vincent
通讯作者：
Rajkumar, S. Vincent
影响因子：
158.5
作者：
Mateos, M. -V.;Dimopoulos, M. A.;San-Miguel, J.
通讯作者：
San-Miguel, J.
影响因子：
10.3
作者：
Rosenberg, Aaron S.;Brunson, Ann;Wun, Ted
通讯作者：
Wun, Ted