Multiple Myeloma Patients Remain On Treatment Far Less than in Clinical Trials, Study Finds

Patients with relapsed or refractory multiple myeloma who are treated with new therapy combinations remain on their treatments far shorter than those participating in clinical trials, a study found.

The research also noted that patients treated with Empliciti (elotuzumab) remained the longest on their medication when compared to other therapies, suggesting that its benefits may be accompanied by an acceptable profile of side effects.

Researchers from SmartAnalyst presented the study’s data at the American Society of Hematology’s 59th Annual Meeting last December.

The study, “Duration of Treatment of Multiple Myeloma Regimens in Patients with Relapsed or Refractory Multiple Myeloma: Findings in US Clinical Practice Settings,” was sponsored by Empliciti’s developer, Bristol-Myers Squibb.

The team looked at combinations of therapies that included Pomalyst (pomalidomide), Kyprolis (carfilzomib), Ninlaro (ixazomib), Empliciti, and Darzalex (daratumumab). These medications are typically used in combination with Revlimid (lenalidomide) and dexamethasone.

Earlier trials show that these combinations improve survival among relapsed or refractory myeloma patients, particularly if treatment continued until the disease progressed. These therapies also are considered to have acceptable safety profiles.

However, upon examining the electronic medical records of 854 patients, who together had 1,745 lines of treatment, the data appeared to tell a different story. It became apparent to researchers that patients remained on their therapies far shorter in a real-world setting than in a clinical trial setting.

Patients treated with Empliciti as a second therapy stayed on their medication the longest, at a median of 17.6 weeks. Empliciti also had the longest duration among patients undergoing later treatment courses.

Those on a second or later treatment course remained on Empliciti-based therapy for a median of 10.8 weeks, a notable difference from the 74 weeks for patients treated with a combination of Empliciti, Revlimid, and dexamethasone, as measured in trials.

Kyprolis came in second, with a median duration of 9.6 weeks among patients on their second or later treatment. Meanwhile, trial data showed that adding Kyprolis to Revlimid and dexamethasone had a median duration of 88 weeks of treatment.

Pomalyst, Ninlaro, and Darzalex followed, respectively, with similar reductions in duration.

The time to next treatment on second-line therapy also was longest for Empliciti, with a median of 6.5 months.

In contrast, when researchers included patients with later-line treatments, Kyprolis topped the list with a median of 4.7 months to next treatment. Next came Pomalyst, with Empliciti-treated patients taking on a new therapy after a median of 3.7 months.

Researchers did not explain the cause of the discrepancies from clinical trial data.

While the data suggest that patients possibly stay on Empliciti longer because of a more favorable safety profile, researchers said they need additional analyses to explore whether longer duration times improve patient outcomes in a real-world setting.