Evaluation of the UK Myeloma Research Alliance risk profile in transplant-ineligible multiple myeloma patients treated with novel agents.

The heterogeneity of multiple myeloma (MM) significantly impacts treatment outcomes. Myeloma risk profile (MRP), introduced by the UK Myeloma Research Alliance, is a novel prognostic model for patients with transplant-ineligible newly diagnosed MM (TIE-NDMM) utilizing easily available clinical parameters. In this study, we evaluated the prognostic value of MRP in TIE-NDMM patients treated with novel agents. We retrospectively analysed the data of 799 evaluable MM patients diagnosed between January 2011 and January 2023, extracted from the Japan Clinical Hematology Research Group-EAST (J-CHARGE)-MM database. Overall survival (OS) differed significantly across the three MRP risk groups (p < 0.01). The MRP risk groups remained independently prognostic when adjusted for treatment period and first-line therapy (medium vs. low: hazard ratio [HR], 1.71; p < 0.01; high vs. low: HR, 2.61; p < 0.01). In subgroup analyses, the MRP classification significantly predicted OS in patients treated with bortezomib-based and lenalidomide-based regimens. However, there was no difference in OS between the MRP risk groups in patients treated with daratumumab-based regimens. MRP is a robust prognostic tool for real-world TIE-NDMM patients treated with novel agents. Further studies are warranted to clarify its prognostic utility in the era of front-line anti-CD38 monoclonal antibody-based therapies.