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
Hauptverfasser: Leleu, Xavier, Gorsh, Boris, Bessou, Antoine, Paka, Prani, De Nascimento, Julie, Colin, Xavier, Landi, Suzanne, Wang, Peter Feng
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container_end_page 134
container_issue 1
container_start_page 125
container_title European journal of haematology
container_volume 111
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
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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 &amp; Sons Ltd.</rights><rights>2023 GSK and The Authors. European Journal of Haematology published by John Wiley &amp; Sons Ltd.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). 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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. 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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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