Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes
Objective Patients with multiple myeloma (MM) typically require multiple regimens and become harder to treat with each line of treatment. Furthermore, there is a lack of direct comparative clinical trial data to guide effective treatment sequencing. A novel model is described comparing alternative M...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Hematology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/16078454.2024.2432815 |
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| author | Maria Teresa Petrucci Sara Bringhen Cristina Entrala Cerezo João Mendes Patrizio Armeni |
| author_facet | Maria Teresa Petrucci Sara Bringhen Cristina Entrala Cerezo João Mendes Patrizio Armeni |
| author_sort | Maria Teresa Petrucci |
| collection | DOAJ |
| description | Objective Patients with multiple myeloma (MM) typically require multiple regimens and become harder to treat with each line of treatment. Furthermore, there is a lack of direct comparative clinical trial data to guide effective treatment sequencing. A novel model is described comparing alternative MM treatment sequences to optimize patient outcomes.Methods The model compares treatment sequences and outcomes for adults with newly diagnosed transplant-eligible (TE) or transplant-ineligible (TIE) MM across four treatment lines (first-line [FL] to fourth-line [4L]). Inputs are derived from patient-level data from clinical trials and indirect treatment comparisons. We report a base case prediction using data representing clinical practice in Italy.Results For FL TE, overall survival (OS) and progression-free survival (PFS) were greatest for FL regimens containing daratumumab; OS ranged from 11.80–18.10 years. PFS ranged from 4.82–13.42 years (FL) to 0.66–6.03 years (second-line [2L]), 0.81–1.76 years (third-line [3L]), and 0.69–0.72 years (4L). For FL TIE, OS rates were greater for treatment sequences with FL daratumumab vs. sequences with either 2L or no daratumumab (OS ranging from 5.95–10.61 years). PFS was greatest for FL daratumumab regimens in the TIE group, with PFS ranging from 2.12–7.48 years (FL), 0.53–4.73 years (2L), 0.63–1.17 years (3L), and 0.42 years (4L).Discussion This novel model demonstrates that using the most effective treatment in FL optimizes treatment sequencing and clinical outcomes for patients.Conclusion The optimal MM treatment sequences begin with daratumumab-containing regimens in FL and improve outcomes compared with alternative sequences. |
| format | Article |
| id | doaj-art-0b787c51bc9b4c1e8e6316ce67bd4c32 |
| institution | Kabale University |
| issn | 1607-8454 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Hematology |
| spelling | doaj-art-0b787c51bc9b4c1e8e6316ce67bd4c322024-12-12T15:08:53ZengTaylor & Francis GroupHematology1607-84542024-12-0129110.1080/16078454.2024.2432815Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomesMaria Teresa Petrucci0Sara Bringhen1Cristina Entrala Cerezo2João Mendes3Patrizio Armeni4Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, ItalySSD Clinical Trials in Oncohematology and Multiple Myeloma, City of Health and Science University Hospital of Turin, Turin, ItalyJanssen-Cilag SA, Madrid, SpainJanssen Global Services LLC, Raritan, USACentre for Research on Health and Social Care Management, SDA Bocconi School of Management, Milan, ItalyObjective Patients with multiple myeloma (MM) typically require multiple regimens and become harder to treat with each line of treatment. Furthermore, there is a lack of direct comparative clinical trial data to guide effective treatment sequencing. A novel model is described comparing alternative MM treatment sequences to optimize patient outcomes.Methods The model compares treatment sequences and outcomes for adults with newly diagnosed transplant-eligible (TE) or transplant-ineligible (TIE) MM across four treatment lines (first-line [FL] to fourth-line [4L]). Inputs are derived from patient-level data from clinical trials and indirect treatment comparisons. We report a base case prediction using data representing clinical practice in Italy.Results For FL TE, overall survival (OS) and progression-free survival (PFS) were greatest for FL regimens containing daratumumab; OS ranged from 11.80–18.10 years. PFS ranged from 4.82–13.42 years (FL) to 0.66–6.03 years (second-line [2L]), 0.81–1.76 years (third-line [3L]), and 0.69–0.72 years (4L). For FL TIE, OS rates were greater for treatment sequences with FL daratumumab vs. sequences with either 2L or no daratumumab (OS ranging from 5.95–10.61 years). PFS was greatest for FL daratumumab regimens in the TIE group, with PFS ranging from 2.12–7.48 years (FL), 0.53–4.73 years (2L), 0.63–1.17 years (3L), and 0.42 years (4L).Discussion This novel model demonstrates that using the most effective treatment in FL optimizes treatment sequencing and clinical outcomes for patients.Conclusion The optimal MM treatment sequences begin with daratumumab-containing regimens in FL and improve outcomes compared with alternative sequences.https://www.tandfonline.com/doi/10.1080/16078454.2024.2432815Multiple myelomadrug therapyprogression-free survivaltreatment sequencingimproved outcomestreatment lines |
| spellingShingle | Maria Teresa Petrucci Sara Bringhen Cristina Entrala Cerezo João Mendes Patrizio Armeni Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes Hematology Multiple myeloma drug therapy progression-free survival treatment sequencing improved outcomes treatment lines |
| title | Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes |
| title_full | Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes |
| title_fullStr | Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes |
| title_full_unstemmed | Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes |
| title_short | Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes |
| title_sort | optimizing treatment sequencing in multiple myeloma a novel model to predict survival outcomes |
| topic | Multiple myeloma drug therapy progression-free survival treatment sequencing improved outcomes treatment lines |
| url | https://www.tandfonline.com/doi/10.1080/16078454.2024.2432815 |
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