A recent analysis found multiple myeloma patients in real-world settings have worse outcomes from standard regimens compared to those reported in clinical trials.
The analysis, presented at the annual meeting of the American Society of Hematology, included nearly 4,000 patients with newly diagnosed and refractory multiple myeloma being treated between 2007 and 2020 in Ontario, Canada. The study looked at outcomes from seven standard regimens and compared them to reported outcomes in phase 3 trials.
The regimens included lenalidomide plus dexamethasone; triple therapy with bortezomib, lenalidomide and dexamethasone; pomalidomide plus dexamethasone; carfilzomib plus dexamethasone; and triple combinations including carfilzomib, lenalidomide and dexamethasone.
The analysis found patients in a real-world setting had worse progression-free and overall survival outcomes in six of seven standard treatments compared to trials. Progression-free survival was at least three to 18 months longer in the clinical trial, with median overall survival at least 19 months longer compared to real-world patients.
The only regimen that had comparable outcomes was pomalidomide and dexamethasone. This could be due to the patients in clinical trials who had similar or more advanced disease than those in the real-world setting, according to the study.