Survival outcomes for patients with multiple myeloma in France: A retrospective cohort study using the Système National des Données de Santé national healthcare database
Objective Evaluate the overall survival (OS) of patients with multiple myeloma (MM) at different treatment stages in France. Methods This retrospective observational cohort study used data from the French National Health Insurance database to study patients with MM (diagnosis 2013–2019). Patient out...
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Veröffentlicht in: | European journal of haematology 2023-07, Vol.111 (1), p.125-134 |
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creator | Leleu, Xavier Gorsh, Boris Bessou, Antoine Paka, Prani De Nascimento, Julie Colin, Xavier Landi, Suzanne Wang, Peter Feng |
description | Objective
Evaluate the overall survival (OS) of patients with multiple myeloma (MM) at different treatment stages in France.
Methods
This retrospective observational cohort study used data from the French National Health Insurance database to study patients with MM (diagnosis 2013–2019). Patient outcomes included OS (all‐cause mortality), time‐to‐next treatment (TTNT), and duration of therapy (DoT) from initial diagnosis, the start of different lines of therapy (LOTs), triple‐class exposure (TCE), and subsequent treatment following TCE. The Kaplan–Meier method analyzed “time‐to‐event” data.
Results
From diagnosis, death rates increased from 1% at 1 month to 24% at 2 years; median OS was 63.8 months (N = 14 309). Median OS from the start of LOTs declined from 61.0 months (LOT1) to 14.8 months (LOT4). Median OS from TCE start was 14.7 months. There was a large variation in TTNT within LOTs (e.g., LOT1: bortezomib + lenalidomide: TTNT = 26.4 months, OS = 61.7 months; lenalidomide: TTNT = 20.0 months, OS = 39.6 months); DoT was similar for LOT1 and LOT2, then progressively declined at LOT4. Patients with stem cell transplant, younger age, and less comorbidity had better survival outcomes.
Conclusions
Patients with MM face a poor prognosis after relapse to multiple LOTs and TCE, demonstrating a worsening of survival outcomes. Access to novel therapies may improve outcomes. |
doi_str_mv | 10.1111/ejh.13976 |
format | Article |
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Evaluate the overall survival (OS) of patients with multiple myeloma (MM) at different treatment stages in France.
Methods
This retrospective observational cohort study used data from the French National Health Insurance database to study patients with MM (diagnosis 2013–2019). Patient outcomes included OS (all‐cause mortality), time‐to‐next treatment (TTNT), and duration of therapy (DoT) from initial diagnosis, the start of different lines of therapy (LOTs), triple‐class exposure (TCE), and subsequent treatment following TCE. The Kaplan–Meier method analyzed “time‐to‐event” data.
Results
From diagnosis, death rates increased from 1% at 1 month to 24% at 2 years; median OS was 63.8 months (N = 14 309). Median OS from the start of LOTs declined from 61.0 months (LOT1) to 14.8 months (LOT4). Median OS from TCE start was 14.7 months. There was a large variation in TTNT within LOTs (e.g., LOT1: bortezomib + lenalidomide: TTNT = 26.4 months, OS = 61.7 months; lenalidomide: TTNT = 20.0 months, OS = 39.6 months); DoT was similar for LOT1 and LOT2, then progressively declined at LOT4. Patients with stem cell transplant, younger age, and less comorbidity had better survival outcomes.
Conclusions
Patients with MM face a poor prognosis after relapse to multiple LOTs and TCE, demonstrating a worsening of survival outcomes. Access to novel therapies may improve outcomes.</description><identifier>ISSN: 0902-4441</identifier><identifier>EISSN: 1600-0609</identifier><identifier>DOI: 10.1111/ejh.13976</identifier><identifier>PMID: 37199133</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Bortezomib ; Cohort analysis ; Comorbidity ; Diagnosis ; France ; line of therapy ; Medical prognosis ; Multiple myeloma ; overall survival ; Patients ; real world ; refractory ; retrospective ; Stem cell transplantation ; triple‐class exposed</subject><ispartof>European journal of haematology, 2023-07, Vol.111 (1), p.125-134</ispartof><rights>2023 GSK and The Authors. published by John Wiley & Sons Ltd.</rights><rights>2023 GSK and The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3886-63c58555c9b5033b1d54951d8e76c3917c05545f30b34ce300b5e725171d15343</citedby><cites>FETCH-LOGICAL-c3886-63c58555c9b5033b1d54951d8e76c3917c05545f30b34ce300b5e725171d15343</cites><orcidid>0000-0001-6977-0220 ; 0009-0000-8770-426X ; 0000-0002-4638-8202</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fejh.13976$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fejh.13976$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37199133$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leleu, Xavier</creatorcontrib><creatorcontrib>Gorsh, Boris</creatorcontrib><creatorcontrib>Bessou, Antoine</creatorcontrib><creatorcontrib>Paka, Prani</creatorcontrib><creatorcontrib>De Nascimento, Julie</creatorcontrib><creatorcontrib>Colin, Xavier</creatorcontrib><creatorcontrib>Landi, Suzanne</creatorcontrib><creatorcontrib>Wang, Peter Feng</creatorcontrib><title>Survival outcomes for patients with multiple myeloma in France: A retrospective cohort study using the Système National des Données de Santé national healthcare database</title><title>European journal of haematology</title><addtitle>Eur J Haematol</addtitle><description>Objective
Evaluate the overall survival (OS) of patients with multiple myeloma (MM) at different treatment stages in France.
Methods
This retrospective observational cohort study used data from the French National Health Insurance database to study patients with MM (diagnosis 2013–2019). Patient outcomes included OS (all‐cause mortality), time‐to‐next treatment (TTNT), and duration of therapy (DoT) from initial diagnosis, the start of different lines of therapy (LOTs), triple‐class exposure (TCE), and subsequent treatment following TCE. The Kaplan–Meier method analyzed “time‐to‐event” data.
Results
From diagnosis, death rates increased from 1% at 1 month to 24% at 2 years; median OS was 63.8 months (N = 14 309). Median OS from the start of LOTs declined from 61.0 months (LOT1) to 14.8 months (LOT4). Median OS from TCE start was 14.7 months. There was a large variation in TTNT within LOTs (e.g., LOT1: bortezomib + lenalidomide: TTNT = 26.4 months, OS = 61.7 months; lenalidomide: TTNT = 20.0 months, OS = 39.6 months); DoT was similar for LOT1 and LOT2, then progressively declined at LOT4. Patients with stem cell transplant, younger age, and less comorbidity had better survival outcomes.
Conclusions
Patients with MM face a poor prognosis after relapse to multiple LOTs and TCE, demonstrating a worsening of survival outcomes. Access to novel therapies may improve outcomes.</description><subject>Bortezomib</subject><subject>Cohort analysis</subject><subject>Comorbidity</subject><subject>Diagnosis</subject><subject>France</subject><subject>line of therapy</subject><subject>Medical prognosis</subject><subject>Multiple myeloma</subject><subject>overall survival</subject><subject>Patients</subject><subject>real world</subject><subject>refractory</subject><subject>retrospective</subject><subject>Stem cell transplantation</subject><subject>triple‐class exposed</subject><issn>0902-4441</issn><issn>1600-0609</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kc1u1DAQxy0EotvCgRdAlrjAIa0d2_ngVpWWgio4FM6R48wSrxw7-GOrvBGV-hb7YrhsywGJuXgk__Sb0fwRekXJMc11ApvxmLK2rp6gFa0IKUhF2qdoRVpSFpxzeoAOQ9gQQsqW1s_RAatp21LGVujuOvmt3kqDXYrKTRDw2nk8y6jBxoBvdBzxlEzUswE8LWDcJLG2-MJLq-A9PsUeondhBhX1FrByo_MRh5iGBaeg7Q8cR8DXS4i7XxPgL9nsbJ435FEfnLW729wMmZA27m6xffwfQZo4KukBDzLKXgZ4gZ6tpQnw8uE9Qt8vzr-dXRZXXz9-Oju9KhRrmqqomBKNEEK1vSCM9XQQvBV0aKCuFMsXUEQILtaM9IwrYIT0AupS0JoOVDDOjtDbvXf27meCELtJBwXGSAsuha5sqCh5S0ST0Tf_oBuXfN7_nioZ4XVeKVPv9pTKlwoe1t3s9ST90lHS3UfY5Qi7PxFm9vWDMfUTDH_Jx8wycLIHbrSB5f-m7vzz5V75Gyq4qNY</recordid><startdate>202307</startdate><enddate>202307</enddate><creator>Leleu, Xavier</creator><creator>Gorsh, Boris</creator><creator>Bessou, Antoine</creator><creator>Paka, Prani</creator><creator>De Nascimento, Julie</creator><creator>Colin, Xavier</creator><creator>Landi, Suzanne</creator><creator>Wang, Peter Feng</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6977-0220</orcidid><orcidid>https://orcid.org/0009-0000-8770-426X</orcidid><orcidid>https://orcid.org/0000-0002-4638-8202</orcidid></search><sort><creationdate>202307</creationdate><title>Survival outcomes for patients with multiple myeloma in France: A retrospective cohort study using the Système National des Données de Santé national healthcare database</title><author>Leleu, Xavier ; Gorsh, Boris ; Bessou, Antoine ; Paka, Prani ; De Nascimento, Julie ; Colin, Xavier ; Landi, Suzanne ; Wang, Peter Feng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3886-63c58555c9b5033b1d54951d8e76c3917c05545f30b34ce300b5e725171d15343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Bortezomib</topic><topic>Cohort analysis</topic><topic>Comorbidity</topic><topic>Diagnosis</topic><topic>France</topic><topic>line of therapy</topic><topic>Medical prognosis</topic><topic>Multiple myeloma</topic><topic>overall survival</topic><topic>Patients</topic><topic>real world</topic><topic>refractory</topic><topic>retrospective</topic><topic>Stem cell transplantation</topic><topic>triple‐class exposed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leleu, Xavier</creatorcontrib><creatorcontrib>Gorsh, Boris</creatorcontrib><creatorcontrib>Bessou, Antoine</creatorcontrib><creatorcontrib>Paka, Prani</creatorcontrib><creatorcontrib>De Nascimento, Julie</creatorcontrib><creatorcontrib>Colin, Xavier</creatorcontrib><creatorcontrib>Landi, Suzanne</creatorcontrib><creatorcontrib>Wang, Peter Feng</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leleu, Xavier</au><au>Gorsh, Boris</au><au>Bessou, Antoine</au><au>Paka, Prani</au><au>De Nascimento, Julie</au><au>Colin, Xavier</au><au>Landi, Suzanne</au><au>Wang, Peter Feng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival outcomes for patients with multiple myeloma in France: A retrospective cohort study using the Système National des Données de Santé national healthcare database</atitle><jtitle>European journal of haematology</jtitle><addtitle>Eur J Haematol</addtitle><date>2023-07</date><risdate>2023</risdate><volume>111</volume><issue>1</issue><spage>125</spage><epage>134</epage><pages>125-134</pages><issn>0902-4441</issn><eissn>1600-0609</eissn><abstract>Objective
Evaluate the overall survival (OS) of patients with multiple myeloma (MM) at different treatment stages in France.
Methods
This retrospective observational cohort study used data from the French National Health Insurance database to study patients with MM (diagnosis 2013–2019). Patient outcomes included OS (all‐cause mortality), time‐to‐next treatment (TTNT), and duration of therapy (DoT) from initial diagnosis, the start of different lines of therapy (LOTs), triple‐class exposure (TCE), and subsequent treatment following TCE. The Kaplan–Meier method analyzed “time‐to‐event” data.
Results
From diagnosis, death rates increased from 1% at 1 month to 24% at 2 years; median OS was 63.8 months (N = 14 309). Median OS from the start of LOTs declined from 61.0 months (LOT1) to 14.8 months (LOT4). Median OS from TCE start was 14.7 months. There was a large variation in TTNT within LOTs (e.g., LOT1: bortezomib + lenalidomide: TTNT = 26.4 months, OS = 61.7 months; lenalidomide: TTNT = 20.0 months, OS = 39.6 months); DoT was similar for LOT1 and LOT2, then progressively declined at LOT4. Patients with stem cell transplant, younger age, and less comorbidity had better survival outcomes.
Conclusions
Patients with MM face a poor prognosis after relapse to multiple LOTs and TCE, demonstrating a worsening of survival outcomes. Access to novel therapies may improve outcomes.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37199133</pmid><doi>10.1111/ejh.13976</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-6977-0220</orcidid><orcidid>https://orcid.org/0009-0000-8770-426X</orcidid><orcidid>https://orcid.org/0000-0002-4638-8202</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Bortezomib Cohort analysis Comorbidity Diagnosis France line of therapy Medical prognosis Multiple myeloma overall survival Patients real world refractory retrospective Stem cell transplantation triple‐class exposed |
title | Survival outcomes for patients with multiple myeloma in France: A retrospective cohort study using the Système National des Données de Santé national healthcare database |
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