Survival of Patients With Multiple Myeloma Has Continued to Improve

Survival of patients with multiple myeloma (MM), including those who are high-risk or elderly, has continued to improve, according to an abstract presented at the 2019 annual meeting of the American Society of Clinical Oncology, held May 31-June 4, 2019, in Chicago, Illinois.

“Treatment of MM has evolved significantly over the past decade, with increasing use of multi-drug combinations for initial therapy. In addition, supportive care approaches have also improved,” researchers said. “We examined how these improvements have translated to survival outcomes in patients with newly diagnosed MM.”

Researchers analyzed data from 3449 patients who were diagnosed with MM between 2004 and 2017 and seen at the Mayo Clinic within 6 months of their diagnosis. Patients were divided into 3 groups depending on the year they were diagnosed:

• group 1 included 831 patients diagnosed between 2004 to 2007
• group 2 included 1161 patients diagnosed between 2008 to 2012
• group 3 included 1457 patients diagnosed between 2013 to 2017.

The median age of the entire cohort was 64 years. Patients ranged in age from 22 to 96 years, and 14% were over 75 years of age, 33% were between 65 to 75 years of age, and 53% were younger than 65 years. The median overall survival (OS) was 5.7 years for the whole cohort, 3.9 years for group 1, 6.3 years for group 2, and not reported for group 3.

Researchers estimated survival of the groups using the Kaplan-Meier method and compared them with the log rank test. Estimated 4-year survival rates were:

• 50% for patients in group 1
• 62% for patients in group 2
• 75% for patients in group 3.

Researchers also explored survival improvements in patient subgroups. They found that while all patients experienced improvements in OS as time progressed, improvement in group 3, the most recently diagnosed, was most conspicuous for those over 75 years old.

In patients younger than 65 years of age, the 4-year survival rate was:

• 57% for group 1
• 71% for group 2
• 79% for group 3.

In patients 65 to 75 years old, the 4-year survival rate was:

• 48% for group 1
• 60% for group 2
• 75% for group 3.

In patients over 75 years old, the 4-year survival rate was:

• 24% for group 1
• 35% for group 2
• 56% for group 3.

The 3-year OS rates for high-risk (HRC) patients compared to those with standard-risk cytogenetics (SRC) varied. Researchers found the survival rates were:

• 52% for patients with HRC and 67% for those with SRC in group 1
• 55% for patients with HRC and 75% for those with SRC in group 2
• 73% for patients with HRC and 85% for those with SRC in group 3

Patients with high-risk disease didn't see great survival benefits in the early period. However, major progress was observed for those patients in group 3.

Disease stage also impacted OS. A total of 2067 patients were staged according to the International Staging System. The median OS was:

• 6.5 years for stage 1 patients in group 1 and 9.2 years for those in group 2
• 4.6 years for stage 2 patients in group 1 and 6.6 years for those in group 2
• 2.4 years for stage 3 patients in group 1 and 3.5 years for those in group 2
• not reported for any of the stages in group 3

“The results confirm continued improvement in survival of newly diagnosed multiple myeloma patients, including elderly and high-risk MM,” researchers concluded.

Reference

Nandakumar B, Binder M, Dispenzieri A, et al. Continued improvement in survival in multiple myeloma (MM) including high-risk patients. Presented at: American Society of Clinical Oncology Annual Meeting; May 31-June 4, 2019; Chicago, Illinois. Suppl Abstract 8039.