Real-World Treatment Patterns and Outcomes in Patients With Relapsed/Refractory Multiple Myeloma and 1-3 Prior Lines of Therapy: Optum Database.

Background: Early (often continuous) treatment of multiple myeloma (MM) with lenalidomide has become common practice, leading to an increase in lenalidomide-refractory disease.

Methods: We report real-world treatment patterns, health care resource utilization (HCRU), and outcomes for patients with lenalidomide-refractory MM using data from Optum US Claims and Optum electronic health record (EHR) databases with index date from January 2016 to March 2022 (Claims) or December 2021 (EHR). Eligible patients had received 1-3 prior lines of therapy (LOT), including a proteasome inhibitor.

Results: A total of 1383 and 1597 patients with lenalidomide-refractory disease were included from the Claims and EHR databases, respectively, with median ages of 72 and 68 years and mean Charlson Comorbidity Index scores of 4.0 and 3.1. The most common treatment combinations were daratumumab-pomalidomide-dexamethasone, daratumumab-bortezomib-dexamethasone, and pomalidomide-dexamethasone (~5% each). From LOT 2 to LOT 6, treatment attrition (patients who died or received no further treatment) was 95.2% to 95.9%. Median time to next treatment was 5.4 (Claims) and 5.9 months (EHR). Median OS was 35.2 (Claims) and 41.2 months (EHR). HCRU was consistent across LOT.

Conclusions: Patients with lenalidomide-refractory MM who received 1-3 prior LOT had poor outcomes and moved quickly through available therapies, demonstrating an unmet need to improve outcomes in this difficult-to-treat patient population.