While real-world data suggest that newer treatments may be improving outcomes among patients with relapsed/refractory multiple myeloma (RRMM), more data are needed to confirm patterns in treatment outcomes, according to research published in Expert Review of Hematology.

MM accounts for about 2% of all cancer-related deaths in the United States, with only about half of diagnosed patients expected to survive more than 5 years after diagnosis.

National Comprehensive Cancer Network (NCCN) guidelines for MM suggest that a bortezomib, lenalidomide, and dexamethasone combination forms the most effective first-line treatment, though the majority of patients are known to relapse. However, in the RRMM setting, a host of new treatments have become available over the past decade, with many studies showing improved survival with the use of newer therapies.

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Given the number of available therapies, there are no consistent treatment guidelines for patients with RRMM, and studies including real world data are limited. To better assess this, researchers manually evaluated real-world data from electronic medical records (EMRs) and charts from community oncology practices around the United States in an effort to determine whether newer therapies unequivocally improve outcomes in the RR setting.

Overall, data from 2057 patients were included, 1601 records came from EMRs and 456 came from chart records. All included patients had received at least 2 lines of therapy; 40% received therapy beyond 2 lines. Thereafter, no single treatment was considered the preferred therapy.

The median real-world progression-free survival (PFS) in the first to fifth lines was 12.0 months to 3.5 months, respectively, while the real-world overall survival (OS) was 48.2 months to 5.8 months, respectively. The use of newer therapies trended towards improved PFS and OS, though this finding was not confirmed.

“The development of further novel agents in the RRMM setting is expected to continue to improve outcomes,” the authors wrote. “[H]owever, this study highlights the importance of ensuring that these new treatments are incorporated into early treatments in the real-world setting so that their benefits are available to a wide range of patients.”

Disclosures: Some authors have declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.


Bruno AS, Willson JL, Opalinska JM, et al. Recent real-world treatment patterns and outcomes in US patients with relapsed/refractory multiple myeloma. Expert Rev Hematol. Published online August 26, 2020. doi:10.1080/17474086.2020.1800451