PMID- 30513016
OWN - NLM
STAT- MEDLINE
DCOM- 20200505
LR  - 20200505
IS  - 1747-4094 (Electronic)
IS  - 1747-4094 (Linking)
VI  - 12
IP  - 1
DP  - 2019 Jan
TI  - Adoption of triplet therapy and clinical outcomes in routine practice among newly 
      diagnosed multiple myeloma patients not receiving frontline stem cell transplant 
      in the USA.
PG  - 71-79
LID - 10.1080/17474086.2019.1555460 [doi]
AB  - BACKGROUND: Immunomodulator (IMID) and proteasome inhibitor (PI) triplet 
      frontline therapy (FT) in newly diagnosed multiple myeloma (NDMM) trials improve 
      overall survival (OS); reported outcomes in routine practice are lacking. Authors 
      compared outcomes in NDMM patients in the USA by use of triplet vs doublet FTs. 
      METHODS: In this retrospective study of NDMM patients without FT transplant 
      between 1/1/2008 and 6/30/2017, FT was categorized as: PI+IMID-triplet (>/= 3 drugs 
      including PI+IMID), non-PI+IMID-triplet (>/= 3 drugs, not PI+IMID), doublet (</= 2 
      drugs). Univariate and multivariate analyses identified FT triplet predictors and 
      compared time-to-next-treatment (TTNT)/OS. RESULTS: Among 4,982 NDMM patients, 
      68% and 32% initiated doublet and triplet FTs (PI+IMID: 36% in 2017). Triplet FT 
      predictors included: age, cytogenetics, ISS stage, certain CRAB symptoms. Median 
      TTNT(PI+IMID-triplet) = 18.9 months vs 13.7 (non-PI+IMID-triplet) and 16.5 months 
      (doublet) FTs (P< 0.01); adjusted HR(PI+IMID-triplet) = 0.86; P= 0.009; 
      HR(non-PI+IMID-triplet) = 1.10; P = 0.083 vs doublet FT. Median 
      OS(PI+IMID-triplet) = 58.7 months vs 43.6 (non-PI+IMID-triplet) and 45.7 months 
      (doublet) FTs (P< 0.01); adjusted HR(PI+IMID-triplet) = 0.83; P= 0.016; 
      HR(non-PI+IMID-triplet) = 1.02; P = 0.727 vs doublet FT. CONCLUSION: 
      PI+IMID-triplet FT is not utilized for most non-frontline-transplant NDMM 
      patients in routine care but is associated with prolonged TTNT/OS.
FAU - Hari, Parameswaran
AU  - Hari P
AD  - a Department of Medicine , Medical College of Wisconsin , Milwaukee , WI , USA.
FAU - Blazer, Marlo
AU  - Blazer M
AD  - b Xcenda, LLC , Palm Harbor , FL , USA.
FAU - Raju, Aditya
AU  - Raju A
AD  - b Xcenda, LLC , Palm Harbor , FL , USA.
FAU - Farrelly, Eileen
AU  - Farrelly E
AD  - b Xcenda, LLC , Palm Harbor , FL , USA.
FAU - Labotka, Richard
AU  - Labotka R
AD  - c Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda 
      Pharmaceutical Company Limited , Cambridge , UK.
FAU - Skacel, Tomas
AU  - Skacel T
AD  - c Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda 
      Pharmaceutical Company Limited , Cambridge , UK.
FAU - Romanus, Dorothy
AU  - Romanus D
AD  - c Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda 
      Pharmaceutical Company Limited , Cambridge , UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20181212
PL  - England
TA  - Expert Rev Hematol
JT  - Expert review of hematology
JID - 101485942
SB  - IM
MH  - Female
MH  - Humans
MH  - Male
MH  - Multiple Myeloma/*therapy
MH  - Stem Cell Transplantation/*methods
MH  - Treatment Outcome
MH  - United States
OTO - NOTNLM
OT  - Newly diagnosed multiple myeloma
OT  - induction therapy
OT  - triplet therapy
EDAT- 2018/12/05 06:00
MHDA- 2020/05/06 06:00
CRDT- 2018/12/05 06:00
PHST- 2018/12/05 06:00 [pubmed]
PHST- 2020/05/06 06:00 [medline]
PHST- 2018/12/05 06:00 [entrez]
AID - 10.1080/17474086.2019.1555460 [doi]
PST - ppublish
SO  - Expert Rev Hematol. 2019 Jan;12(1):71-79. doi: 10.1080/17474086.2019.1555460. 
      Epub 2018 Dec 12.