Clinical and Sociodemographic Characteristics of Patients with Relapsed and/or Refractory Multiple Myeloma and their influence on Treatment in the Real-World Setting in Spain: the CharisMMa Study

Abstract

The characteristics of patients with RRMM in the real-world setting often differ from those enrolled in clinical trials, challenging therapeutic decisions in day-to-day practice. We retrospectively analyzed the sociodemographic and clinical characteristics of RRMM patients treated in routine clinical practice and their influence on the prescribing patterns in this setting. Treatment patterns among 276 RRMM patients from multiple hospitals were highly heterogeneous. The prescribed regimen was primarily influenced by the number of previous lines and the presence of osteopenia and extramedullary plasmacytomas. Our results rise awareness on the heterogeneity of the therapeutic landscape of RRMM in the real-world and highlight the complexity of therapeutic decision making in this population. Introduction: Treatment of relapsed and/or refractory multiple myeloma (RRMM) should be established based on multiple factors, including previous treatment and the sociodemographic/clinical characteristics of the patients. However, patients enrolled in randomized-controlled trials often do not mirror the scenario encountered in real-world practice, thus challenging therapeutic decisions in day-to-day practice. Patients and methods: This observational, cross-sectional, multicenter study aimed to investigate the sociodemographic and clinical characteristics of patients with RRMM treated in routine practice in Spain and their influence on treatment regimens. Results: The study included 276 RRMM patients (median age 69 years; no gender predominance). Seventy-four percent of patients had CRAB features at the time of study inclusion, 65.9% bone lesions, 28.7% high-risk cytogenetics, and 27.0% were at ISS stage III; 65.1% were retired and lived in urban areas (75.7%) with their relatives (85.8%); 28.7% had some dependence degree. Patients had experienced their last relapse in a median of 1.61 months before enrollment and had received a median of 2 treatment lines (range 1-10). Second-and third-line therapies were mostly based on immunomodulatory drugs, followed by proteasome inhibitors (PIs), whereas monoclonal antibodies prevailed in later treatment lines. The presence of extramedullary plasmacytomas, the absence of osteopenia, and being in the second or third treatment line (vs. later lines) significantly increased the odds of receiving PIs. Conclusions: RRMM treatment in the real-world setting is highly heterogeneous and is pr imar ily influenced by the number of previous lines. The consideration of patients' clinical and sociodemographic characteristics may support clinicians in making therapeutic decisions.