Trends in the multiple myeloma treatment landscape and survival: a US analysis using 2011-2019 oncology clinic electronic health record data
Trends in the multiple myeloma treatment landscape and survival: a US analysis using 2011-2019 oncology clinic electronic health record data
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DOI：
10.1080/10428194.2020.1827253
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发表时间：
2020-10-06
影响因子：
2.6
通讯作者：
Kim, Christopher
中科院分区：
文献类型：
--
作者：
Braunlin, Megan;Belani, Rajesh;Kim, Christopher
随着新型免疫调节酰亚胺药物 (IMiD)、单克隆抗体 (MoAB) 和蛋白酶体抑制剂 (PI) 的批准，多发性骨髓瘤治疗不断发展。我们使用多发性骨髓瘤患者的 Flatiron 数据（从治疗指数到死亡/数据结束）描述了 2011 年至 2019 年美国的治疗趋势和生存率。患者 (n = 10,553) 主要 (88%) 在社区中心接受治疗。一线 PI-IMiD-地塞米松的使用量随着时间的推移而增加，而 IMiD-地塞米松和 PI-地塞米松的使用量则减少。 MoAB-IMiD-地塞米松在复发/难治性疾病中的使用增加。在所有系列中，双联体的使用减少，三联体的使用增加，到 2018 年至 2019 年，三联体成为处方最多的组合，尤其是在一线（62%）。一线用药的单一疗法使用率下降（19% 至 10%），但在复发/难治性疾病中的使用率保持稳定（与 20% 相似）。随着治疗方案的增加，中位总生存期下降（60、48、36、29、23 个月）。随着最近的诊断，生存率增加。我们的结果表明，多发性骨髓瘤的情况在过去十年中发生了显着变化。
Multiple myeloma treatment has evolved with approvals of new immunomodulatory imide drugs (IMiDs), monoclonal antibodies (MoABs), and proteasome inhibitors (PIs). We characterized U.S. treatment trends and survival from 2011 to 2019 using Flatiron data from multiple myeloma patients followed from treatment index until death/end of data. Patients (n = 10,553) were primarily (88%) treated in community centers. Frontline PI-IMiD-dexamethasone use increased over time, while IMiD-dexamethasone and PI-dexamethasone use decreased. MoAB-IMiD-dexamethasone use increased in relapsed/refractory disease. In all lines, use of doublets decreased and triplets increased, with triplets becoming the most prescribed combination by 2018-2019, especially in first line (62%). Monotherapy use decreased in first line (19% to 10%) but remained steady in relapsed/refractory disease (similar to 20%). With each increasing line of therapy, median overall survival decreased (60, 48, 36, 29, 23 months). Survival increased with more recent diagnosis. Our results indicate that the multiple myeloma landscape has evolved significantly in the last decade.