PMID- 38431522
OWN - NLM
STAT- Publisher
LR  - 20240302
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
DP  - 2024 Feb 14
TI  - Treatment Pattern, Healthcare Resource Utilization and Symptom Burden Among 
      Patients with Triple Class Exposed Multiple Myeloma: A Population-Based Cohort 
      Study.
LID - S2152-2650(24)00065-X [pii]
LID - 10.1016/j.clml.2024.02.006 [doi]
AB  - PURPOSE: This study aims to describe the treatment patterns, outcomes, health 
      care utilization and symptom burden of triple class exposed (TCE) 
      relapsed/refractory patents with multiple myeloma (MM) receiving a subsequent 
      line of treatment (LOT). METHODS: This is a retrospective observational cohort 
      study using administrative databases in Ontario, Canada. Outcomes were captured 
      for TCE patients receiving a subsequent LOT and included: treatment regimen 
      details, time to next treatment (TTNT), overall survival (OS), health care 
      utilization, palliative care referral, and patient reported symptoms. RESULTS: Of 
      the 16,777 patients diagnosed with MM between 2007-2021 in Ontario, 1358 (8%) 
      patients were classified as TCE. Among the TCE MM patients, 489 (36%) received a 
      subsequent LOT. The two most commonly administered therapies post TCE were 
      carfilzomib/dexamethasone (n = 111, 22%) and pomalidomide/dexamethasone(n = 95, 
      19%). Median TTNT was 1.7 months (95%CI 1.2-2.4 months) and median OS 12.8 months 
      (95%CI 10.8-16.5). Healthcare utilization was high with 276 (56%) of patients 
      evaluated in an emergency department (ED) or admitted to hospital. There was high 
      symptom burden as reported by patients with moderate-severe impairment in 
      well-being, fatigue, pain and drowsiness noted in greater than 25% of the cohort. 
      Palliative care referrals rates were low with only 10% (n = 48) patients referred 
      to palliative care. Among the patients that died during study follow up, the 
      majority died in hospital (n = 147,44%). CONCLUSION: Our study reports one of the 
      largest series of real-world TCE patients published and demonstrates the poor 
      outcomes of TCE patients receiving a subsequent LOT.
CI  - Copyright (c) 2024. Published by Elsevier Inc.
FAU - Mian, Hira
AU  - Mian H
AD  - Department of Oncology, McMaster University, 699 Concession Street, Hamilton, 
      Ontario L8V 5C2, Canada. Electronic address: hira.mian@medportal.ca.
FAU - Seow, Hsien
AU  - Seow H
AD  - Department of Oncology, McMaster University, 699 Concession Street, Hamilton, 
      Ontario L8V 5C2, Canada.
FAU - Pond, Gregory R
AU  - Pond GR
AD  - Department of Oncology, McMaster University, 699 Concession Street, Hamilton, 
      Ontario L8V 5C2, Canada.
FAU - Gayowsky, Anastasia
AU  - Gayowsky A
AD  - ICES, McMaster University, 1290 Main Street West, HSC 4N43, Hamilton, Ontario L8S 
      4K1, Canada.
FAU - Foley, Ronan
AU  - Foley R
AD  - Department of Oncology, McMaster University, 699 Concession Street, Hamilton, 
      Ontario L8V 5C2, Canada.
FAU - Balistky, Amaris
AU  - Balistky A
AD  - Department of Oncology, McMaster University, 699 Concession Street, Hamilton, 
      Ontario L8V 5C2, Canada.
FAU - Ebraheem, Mohammed
AU  - Ebraheem M
AD  - Department of Oncology, McMaster University, 699 Concession Street, Hamilton, 
      Ontario L8V 5C2, Canada.
FAU - Cipkar, Christopher
AU  - Cipkar C
AD  - Department of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario K1H 
      8M5, Canada.
FAU - Sapru, Hyra
AU  - Sapru H
AD  - Department of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario K1H 
      8M5, Canada.
FAU - Mohyuddin, Ghulam Rehman
AU  - Mohyuddin GR
AD  - Department of Medicine, University of Utah, 27 S Mario Capecchi Dr, Salt Lake 
      City, Utah 84113, USA.
FAU - Hadidi, Samer Al
AU  - Hadidi SA
AD  - Department of Medicine, University of Arkansas for Medical Sciences, 4301 W 
      Markham St, Little Rock, Arkansas 72205, USA.
FAU - Visram, Alissa
AU  - Visram A
AD  - Department of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario K1H 
      8M5, Canada.
LA  - eng
PT  - Journal Article
DEP - 20240214
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
SB  - IM
OTO - NOTNLM
OT  - Burden of care
OT  - Health services
OT  - Hematologic malignancies
OT  - Quality of life
OT  - Relapsed/Refractory
COIS- Declaration of competing interest None.
EDAT- 2024/03/03 17:42
MHDA- 2024/03/03 17:42
CRDT- 2024/03/02 21:57
PHST- 2024/01/09 00:00 [received]
PHST- 2024/02/09 00:00 [accepted]
PHST- 2024/03/03 17:42 [medline]
PHST- 2024/03/03 17:42 [pubmed]
PHST- 2024/03/02 21:57 [entrez]
AID - S2152-2650(24)00065-X [pii]
AID - 10.1016/j.clml.2024.02.006 [doi]
PST - aheadofprint
SO  - Clin Lymphoma Myeloma Leuk. 2024 Feb 14:S2152-2650(24)00065-X. doi: 
      10.1016/j.clml.2024.02.006.