Triplet or Quadruplet Regimen Utilization and Overall Survival in Patients Diagnosed With Multiple Myeloma Between 2017 and 2023.

INTRODUCTION

Multiple myeloma treatment has rapidly evolved, but little is known about the uptake of guideline-recommended triplet or quadruplet therapy in clinical practice.

METHODS

This retrospective cohort study included adult patients newly diagnosed with multiple myeloma between January 1, 2017, and December 31, 2023, in one health system in Ohio and Florida. Receipt of triplet or quadruplet therapy within 1 year of diagnosis was quantified to investigate its association with sociodemographic and clinical factors, using a multivariable logistic regression model. We also captured patients' overall survival (OS) through September 30, 2025, using the Cleveland Clinic electronic health record, including linked state and federal death records.

RESULTS

We identified 1230 patients, with mean (SD) age at diagnosis of 67.2 (11.1), 54.1% male, 74.1% White, and 22.8% Black. Within 1 year of diagnosis, 707 (57.5%) patients received either triplet or quadruplet therapy. Utilization increased from 57.1% to 65.9% between 2017 and 2023. In a multivariable logistic regression model, patients who were older, resided in more disadvantaged neighborhoods, or were treated at a Florida regional hospital (vs. Taussig Cancer Center) had lower odds of triplet or quadruplet regimen within 1 year of diagnosis, while those diagnosed in 2023, treated at an Ohio regional hospital, having an eGFR < 60, or a Charlson Comorbidity Score of ≥ 3 had higher odds. The probability of 5-year OS in the cohort was 62.1% (95% CI, 59.0%-65.4%).

CONCLUSION

Our real-world data demonstrate the association of sociodemographic and clinical factors with therapy selection and show improved 5-year OS in clinical practice compared to historical trends.

TRIAL REGISTRATION: The authors have confirmed clinical trial registration is not needed for this submission.