Assessing Frontline Treatment Regimens for Newly Diagnosed Patients with MM Who Did Not Receive Transplantation

Longer frontline therapy for patients with newly diagnosed multiple myeloma (MM) who did not receive autologous hematopoietic cell transplantation (AHCT) are associated with increased survival, according to a study published in Advances in Therapy. 

To conduct this study, patients older than 45 years who had not received AHCT were retrospectively identified using two databases. The researchers used Cox proportional hazard models to compare overall survival (OS) among patients who received bortezomib plus lenalidomide and dexamethasone (VRd), lenalidomide plus dexamethasone (Rd), cyclophosphamide plus bortezomib and dexamethasone (CyBorD), or bortezomib plus dexamethasone (Vd). To address immortal time bias, time-fixed and -dependent Cox models were employed to estimate the association of longer frontline treatment exposure with outcomes.

After propensity score matching, the results showed that longer frontline treatment duration was associated with better OS for overall frontline treatment (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.82-0.90), as well as Vd (HR, 0.81; 95% CI, 0.74-0.89), CyBorD (HR, 0.79; 95% CI, 0.64-0.98), and Rd (HR, 0.86; 95% CI, 0.78-0.95) regimens.

“Results demonstrated that the frontline therapies prescribed to most patients who did not receive AHCT for MM in the United States were consistent with the National Comprehensive Cancer Network guideline recommendations,” the researchers concluded.