Sikander Ailawadhi , Mu Cheng , Dasha Cherepanov , Maral DerSarkissian , Dawn Marie Stull , Annalise Hilts , Justin Chun , Mei Sheng Duh , Larysa Sanchez
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The index date was the date of initiation of each LOT and baseline was the 6-month pre-index period. Duration of therapy (DOT), time to next therapy (TTNT), progression-free survival (PFS), and overall survival (OS) were compared across regimens with multivariable Cox proportional hazards models.</p></div><div><h3>Results</h3><p>Of the 1,185 patients contributing 1,332 LOTs, 985 had standard cytogenetic risk (median age, 71 years) and 180 had high risk (median age, 69 years). Compared with other regimens, DRd was associated with longer DOT overall (adjusted hazard ratio [95 % confidence interval]: 1.84 [1.42, 2.38] vs. KRd, 1.65 [1.20, 2.28] vs. ERd, 1.58 [1.23, 2.04] vs. IRd, and 1.54 [1.18, 2.00] vs. VRd), and longer TTNT and PFS. KRd was associated with shorter OS compared with DRd (1.45 [1.01, 2.08]) and VRd (1.32 [1.01, 1.73]). High-risk patients had similar outcomes with all triplet regimens.</p></div><div><h3>Conclusion</h3><p>Although DRd improved clinical outcomes overall, Rd-based triplet regimens containing a PI or MAB are similarly effective in high-risk RRMM.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"50 ","pages":"Article 101078"},"PeriodicalIF":2.5000,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative effectiveness of lenalidomide/dexamethasone-based triplet regimens for treatment of relapsed and/or refractory multiple myeloma in the United States: An analysis of real-world electronic health records data\",\"authors\":\"Sikander Ailawadhi , Mu Cheng , Dasha Cherepanov , Maral DerSarkissian , Dawn Marie Stull , Annalise Hilts , Justin Chun , Mei Sheng Duh , Larysa Sanchez\",\"doi\":\"10.1016/j.currproblcancer.2024.101078\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>This retrospective longitudinal study compared the effectiveness of dexamethasone+lenalidomide (Rd)-based triplet regimens containing proteasome inhibitors (PIs) ixazomib (IRd), carfilzomib (KRd), and bortezomib (VRd) or monoclonal antibodies (MABs) elotuzumab (ERd) and daratumumab (DRd) in patients with relapsed/refractory multiple myeloma (RRMM)—including those with high cytogenetic risk—primarily treated at community oncology clinics in the United States.</p></div><div><h3>Methods</h3><p>Electronic health records of adult RRMM patients in a deidentified real-world database (01/01/2014–09/30/2020) who initiated IRd, KRd, VRd, ERd, or DRd in the second or later line of therapy (LOT) were analyzed. The index date was the date of initiation of each LOT and baseline was the 6-month pre-index period. Duration of therapy (DOT), time to next therapy (TTNT), progression-free survival (PFS), and overall survival (OS) were compared across regimens with multivariable Cox proportional hazards models.</p></div><div><h3>Results</h3><p>Of the 1,185 patients contributing 1,332 LOTs, 985 had standard cytogenetic risk (median age, 71 years) and 180 had high risk (median age, 69 years). Compared with other regimens, DRd was associated with longer DOT overall (adjusted hazard ratio [95 % confidence interval]: 1.84 [1.42, 2.38] vs. KRd, 1.65 [1.20, 2.28] vs. ERd, 1.58 [1.23, 2.04] vs. IRd, and 1.54 [1.18, 2.00] vs. VRd), and longer TTNT and PFS. KRd was associated with shorter OS compared with DRd (1.45 [1.01, 2.08]) and VRd (1.32 [1.01, 1.73]). 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引用次数: 0
摘要
背景这项回顾性纵向研究比较了以地塞米松+来那度胺（Rd）为基础的三联方案（包含蛋白酶体抑制剂（PIs）ixazomib（IRd）、carfilzomib（KRd）和硼替佐米（VRd））或单克隆抗体（MABs）elotuzumab（ERd）和daratumumab（DRd））对复发/难治性骨髓瘤患者的疗效、和硼替佐米（VRd）或单克隆抗体（MAB）艾洛妥珠单抗（ERd）和达拉单抗（DRd）的三联疗法治疗复发性/难治性多发性骨髓瘤（RRMM）患者（包括细胞遗传学风险较高的患者），这些患者主要在美国的社区肿瘤诊所接受治疗。方法分析了一个去身份化真实世界数据库中成年 RRMM 患者的电子健康记录（01/01/2014-09/30/2020），这些患者在二线或二线以上疗法（LOT）中开始接受 IRd、KRd、VRd、ERd 或 DRd 治疗。索引日期为每个 LOT 的开始日期，基线为索引前的 6 个月。采用多变量考克斯比例危险模型比较了不同方案的治疗持续时间（DOT）、下一次治疗时间（TTNT）、无进展生存期（PFS）和总生存期（OS）。结果 在接受 1,332 LOT 治疗的 1,185 名患者中，985 人具有标准细胞遗传学风险（中位年龄 71 岁），180 人具有高风险（中位年龄 69 岁）。与其他治疗方案相比，DRd 的总 DOT 时间更长（调整后危险比 [95 % 置信区间]：1.84 [1.42，1.42]）：1.84 [1.42, 2.38] vs. KRd, 1.65 [1.20, 2.28] vs. ERd, 1.58 [1.23, 2.04] vs. IRd, and 1.54 [1.18, 2.00] vs. VRd），TTNT 和 PFS 更长。与DRd（1.45 [1.01, 2.08]）和VRd（1.32 [1.01, 1.73]）相比，KRd的OS更短。结论虽然DRd改善了总体临床疗效，但基于Rd的含有PI或MAB的三联方案对高危RRMM同样有效。
Comparative effectiveness of lenalidomide/dexamethasone-based triplet regimens for treatment of relapsed and/or refractory multiple myeloma in the United States: An analysis of real-world electronic health records data
Background
This retrospective longitudinal study compared the effectiveness of dexamethasone+lenalidomide (Rd)-based triplet regimens containing proteasome inhibitors (PIs) ixazomib (IRd), carfilzomib (KRd), and bortezomib (VRd) or monoclonal antibodies (MABs) elotuzumab (ERd) and daratumumab (DRd) in patients with relapsed/refractory multiple myeloma (RRMM)—including those with high cytogenetic risk—primarily treated at community oncology clinics in the United States.
Methods
Electronic health records of adult RRMM patients in a deidentified real-world database (01/01/2014–09/30/2020) who initiated IRd, KRd, VRd, ERd, or DRd in the second or later line of therapy (LOT) were analyzed. The index date was the date of initiation of each LOT and baseline was the 6-month pre-index period. Duration of therapy (DOT), time to next therapy (TTNT), progression-free survival (PFS), and overall survival (OS) were compared across regimens with multivariable Cox proportional hazards models.
Results
Of the 1,185 patients contributing 1,332 LOTs, 985 had standard cytogenetic risk (median age, 71 years) and 180 had high risk (median age, 69 years). Compared with other regimens, DRd was associated with longer DOT overall (adjusted hazard ratio [95 % confidence interval]: 1.84 [1.42, 2.38] vs. KRd, 1.65 [1.20, 2.28] vs. ERd, 1.58 [1.23, 2.04] vs. IRd, and 1.54 [1.18, 2.00] vs. VRd), and longer TTNT and PFS. KRd was associated with shorter OS compared with DRd (1.45 [1.01, 2.08]) and VRd (1.32 [1.01, 1.73]). High-risk patients had similar outcomes with all triplet regimens.
Conclusion
Although DRd improved clinical outcomes overall, Rd-based triplet regimens containing a PI or MAB are similarly effective in high-risk RRMM.
期刊介绍：
Current Problems in Cancer seeks to promote and disseminate innovative, transformative, and impactful data on patient-oriented cancer research and clinical care. Specifically, the journal''s scope is focused on reporting the results of well-designed cancer studies that influence/alter practice or identify new directions in clinical cancer research. These studies can include novel therapeutic approaches, new strategies for early diagnosis, cancer clinical trials, and supportive care, among others. Papers that focus solely on laboratory-based or basic science research are discouraged. The journal''s format also allows, on occasion, for a multi-faceted overview of a single topic via a curated selection of review articles, while also offering articles that present dynamic material that influences the oncology field.
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