Lenalidomide combination therapy is commonly used for patients with newly diagnosed and relapsed/refractory multiple myeloma (MM). However, as lenalidomide is often given until progression, a growing population of lenalidomide-refractory patients presents challenges for subsequent therapy. Researchers of this study analyzed real-world data from 1455 lenalidomide-refractory patients with MM who had received 1 to 3 prior lines of therapy (LOT). Treatment patterns showed that doublet and triplet regimens were most commonly used, with significant use of non-NCCN-recommended treatments. High attrition rates (43%-54%) were observed, and the median overall survival was 44.4 months.
Despite available treatments, progression-free survival (PFS) and overall survival were suboptimal, particularly for those with 1 to 3 prior LOTs. Outcomes were similar across prior LOTs, indicating rapid disease progression. Poor prognostic factors included International Staging System stage III, Eastern Cooperative Oncology Group performance status of 1, high-risk cytogenetics, and refractoriness to anti-CD38 monoclonal antibodies. The study emphasizes the need for therapies that can extend PFS, and researchers recommend earlier treatment to improve long-term outcomes.
Reference: Dhakal B, Einsele H, Schecter JM, et al. Real-world treatment patterns and outcomes in relapsed/refractory multiple myeloma (1-3 prior lines): Flatiron database. Blood Adv. 2024;8(19):5062-5071. doi: 10.1182/bloodadvances.2024012640.