Front‐line treatment efficacy and clinical outcomes of elderly patients with multiple myeloma in a real‐world setting: A multicenter retrospective study in China

• Published in: Cancer medicine (Malden, MA) MA), 2023-02, Vol.12 (3), p.3101-3111
• Main Authors: Bao, Li, Liu, Ai‐Jun, Chu, Bin, Wang, Qian, Dong, Yu‐Jun, Lu, Min‐Qiu, Shi, Lei, Gao, Shan, Wang, Yu‐Tong, Wang, Li‐Fang, Chen, Wen‐Ming, Zhuang, Jun‐Ling
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Autografts; Bone marrow; Chemotherapy; Clinical outcomes; Dehydrogenases; Disease-Free Survival; Females; Frailty; front‐line treatment; Geriatrics; Hematopoietic Stem Cell Transplantation; Hemoglobin; Humans; Immunologic Factors - therapeutic use; Immunomodulating Agents; Immunomodulation; immunomodulatory drugs; Immunosuppressive agents; Males; Multiple myeloma; Multiple Myeloma - drug therapy; Multivariate analysis; overall survival; Patients; Plasma; Proteasome inhibitors; Proteasomes; Remission; Retrospective Studies; Stem cell transplantation; Transplantation, Autologous; Transplants & implants; Treatment Outcome
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.5234

Background The use of proteasome inhibitors (PIs), new immune modulators (IMiDs), and other new drugs, as well as high‐dose chemotherapy combined with autologous stem cell transplantation has considerably improved the survival of young patients with multiple myeloma (MM). However, the improvement in survival among elderly patients remains insufficient. Optimal treatment recommendation models for elderly patients with MM have not been developed especially there are quite few study in the real world. Methods We retrospectively analyzed the treatment patterns and outcomes of 328 Chinese patients (≥65 years) with MM in a real‐world setting. Patients were divided into three groups according to induction regimens. Results The median age of the cohort was 70 (65–86) years. The patients were divided into group 1 (PIs based regimens, n = 218), group 2 (IMiDs based regimens, n = 48) and group 3 (PIs + IMiDs, n = 62). Induction regimens in group 3 produced higher overall response rate than group 1 and 2 (85.42% vs. 71.08% vs. 66.67%, p = 0.016). The median follow‐up of the cohort was 30 (interquartile range [IQR] 18–36) months. For the entire cohort median progression‐free survival (PFS) was 26 (IQR 12.00–42.89) months and overall survival (OS) was 60 (IQR 40.00–67.20) months. The PFS were not significantly different among the three groups (28 months vs. 18 months vs. 26 months, p = 0.182). So were the OS (60 months vs. 59 months vs. not reached, p = 0.067). Multivariate analysis revealed that age >70 year, frailty status (Geriatric vulnerability score), induction efficacy