Real-world characteristics and outcomes of patients with multiple myeloma receiving second-line treatment in England

Despite recent advances in first-line therapies for multiple myeloma (MM), most patients relapse or become refractory, underscoring the need for effective second-line (2L) regimens for relapsed/refractory MM (RRMM). This study describes the real-world baseline characteristics, treatment patterns and clinical outcomes of adult patients diagnosed with MM between 2013 and 2020 using data collated by the National Cancer Registration and Analysis Service (NCRAS) of the National Health Service in England. The study cohorts were broadly aligned to the eligibility criteria of the ongoing DREAMM-7 (D7) and DREAMM-8 (D8) clinical trials. We focus on lenalidomide-exposed/refractory patients who received daratumumab-bortezomib-dexamethasone (DaraVd) at 2L in both cohorts. In the D7-like cohort, the lenalidomide-exposed ( = 282) and lenalidomide-refractory ( = 143) patients who received DaraVd at 2L had a median (95% confidence interval [CI]) time to next treatment or death (TTNTD) of 15.1 (12.6-22.4) and 10.3 (7.4-13.9) months, respectively. In the D8-like cohort, the lenalidomide-exposed ( = 269) and lenalidomide-refractory ( = 148) patients who received DaraVd at 2L had a median (95% CI) TTNTD of 14.5 (11.7-19.7) and 10.0 (7.3-13.7) months, respectively. Patients with RRMM in England receiving DaraVd at 2L have poor clinical outcomes, highlighting the urgent need for new therapies, particularly for lenalidomide-refractory patients.