Correlation between duration of first-line treatment with daratumumab, lenalidomide, and dexamethasone and overall survival in patients with transplant-ineligible multiple myeloma in Japan.

OBJECTIVE: Optimal management of multiple myeloma (MM) remains challenging, particularly among patients with transplant-ineligible newly diagnosed MM (TIE NDMM). Daratumumab + lenalidomide + dexamethasone (DRd) is approved in Japan for the treatment of TIE NDMM. A previously reported real-world, retrospective study of claims from the Japanese Medical Data Vision (MDV) database reported that first-line (1 L) DRd may improve outcomes versus second-line or later treatment in patients with TIE NDMM.

METHODS: Data from this study underwent further analysis to investigate the correlation between 1 L DRd duration of treatment (DoT) and overall survival (OS). DoT and OS outcomes were also assessed in subgroups defined by age (<75, ≥75 to <80, ≥80 years) and Charlson Comorbidity Index (CCI; low [score 0], medium [1 or 2], high [3 or 4] or very high [≥5]).

RESULTS: Of 35,581 patients in the MDV database with a diagnosis of MM between January 1, 2016 and October 31, 2023, 200 patients (median age 77 years, median time from MM diagnosis 16 days) were prescribed 1 L DRd and had baseline/demographic data available at the start of treatment. After a median follow-up of 12.8 months, 1 L DRd DoT (median 26.9 months) showed high-positive correlation with OS (not reached) using Pearson's (r = 0.832), Spearman's rank (rs=0.777), Kendall's Tau (τb=0.703), and Fleischer's (Corr [DoT, OS] = 0.789) coefficients in the overall population, and moderate- or high-positive correlation with OS across age and CCI score subgroups.

CONCLUSION: These findings suggest that 1 L DRd DoT is a potential predictor of OS when used in Japanese clinical practice.