Hematology (Amsterdam, Netherlands) · 2024
Optimizing treatment sequencing in multiple myeloma: a novel model to predict survival outcomes.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Petrucci Maria Teresa, Bringhen Sara, Entrala Cerezo Cristina, Mendes João, Armeni Patrizio
Аннотация
OBJECTIVE: Patients with multiple myeloma (MM) typically require multiple regimens and become harder to treat with each line of treatment. Furthermore, there is a lack of direct comparative clinical trial data to guide effective treatment sequencing. A novel model is described comparing alternative MM treatment sequences to optimize patient outcomes.
METHODS: The model compares treatment sequences and outcomes for adults with newly diagnosed transplant-eligible (TE) or transplant-ineligible (TIE) MM across four treatment lines (first-line [FL] to fourth-line [4L]). Inputs are derived from patient-level data from clinical trials and indirect treatment comparisons. We report a base case prediction using data representing clinical practice in Italy.
RESULTS: For FL TE, overall survival (OS) and progression-free survival (PFS) were greatest for FL regimens containing daratumumab; OS ranged from 11.80-18.10 years. PFS ranged from 4.82-13.42 years (FL) to 0.66-6.03 years (second-line [2L]), 0.81-1.76 years (third-line [3L]), and 0.69-0.72 years (4L). For FL TIE, OS rates were greater for treatment sequences with FL daratumumab vs. sequences with either 2L or no daratumumab (OS ranging from 5.95-10.61 years). PFS was greatest for FL daratumumab regimens in the TIE group, with PFS ranging from 2.12-7.48 years (FL), 0.53-4.73 years (2L), 0.63-1.17 years (3L), and 0.42 years (4L).
DISCUSSION: This novel model demonstrates that using the most effective treatment in FL optimizes treatment sequencing and clinical outcomes for patients.
CONCLUSION: The optimal MM treatment sequences begin with daratumumab-containing regimens in FL and improve outcomes compared with alternative sequences.
METHODS: The model compares treatment sequences and outcomes for adults with newly diagnosed transplant-eligible (TE) or transplant-ineligible (TIE) MM across four treatment lines (first-line [FL] to fourth-line [4L]). Inputs are derived from patient-level data from clinical trials and indirect treatment comparisons. We report a base case prediction using data representing clinical practice in Italy.
RESULTS: For FL TE, overall survival (OS) and progression-free survival (PFS) were greatest for FL regimens containing daratumumab; OS ranged from 11.80-18.10 years. PFS ranged from 4.82-13.42 years (FL) to 0.66-6.03 years (second-line [2L]), 0.81-1.76 years (third-line [3L]), and 0.69-0.72 years (4L). For FL TIE, OS rates were greater for treatment sequences with FL daratumumab vs. sequences with either 2L or no daratumumab (OS ranging from 5.95-10.61 years). PFS was greatest for FL daratumumab regimens in the TIE group, with PFS ranging from 2.12-7.48 years (FL), 0.53-4.73 years (2L), 0.63-1.17 years (3L), and 0.42 years (4L).
DISCUSSION: This novel model demonstrates that using the most effective treatment in FL optimizes treatment sequencing and clinical outcomes for patients.
CONCLUSION: The optimal MM treatment sequences begin with daratumumab-containing regimens in FL and improve outcomes compared with alternative sequences.