CoChat
Sign Up
Cited by 127Multiple Myeloma Research and TreatmentsChronic Lymphocytic Leukemia ResearchAmyloidosis: Diagnosis, Treatment, Outcomes

Frontline treatment patterns and attrition rates by subsequent lines of therapy in patients with newly diagnosed multiple myeloma

Open access
Fonseca, Rafael, Usmani, Saad Z., Mehra, Maneesha, Slavcev, Mary, He, Jianming, Cote, Sarah, Lam, Annette, Ukropec, Jon +4 more·2020·BMC Cancer
DOI 10.1186/s12885-020-07503-yPMC PMC7656738
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: For patients with multiple myeloma (MM), each additional line of therapy (LOT) is associated with lower response rates, shorter treatment duration and treatment-free intervals, and increased rates of toxicities and comorbidities. Here, we examine frontline treatment patterns, and attrition rates by LOT among newly diagnosed MM (NDMM) patients in the United States who were eligible or ineligible for autologous stem cell transplant (ASCT). Methods: Data were identified from three US patient-level databases collectively covering the period January 2000 to September 2018. Patients had an index diagnosis of MM on or after January 1, 2007, medical and prescription insurance coverage at diagnosis, a 1-year look-back period prior to the index diagnosis, no prior malignancies in the 1-year period before index diagnosis, and had received ≥1 LOT. Results: Among patients who did not receive ASCT (non-transplant; n = 22,062), 12,557 (57%) received only 1 LOT and 9505 (43%) received > 1 LOT. Patients receiving only 1 LOT were significantly older, had higher mean Charlson Comorbidity Index (CCI) scores, and higher incidences of comorbidities. Among the 2763 patients receiving ASCT, 2184 received > 1 LOT, and 579 (21%) received only 1 LOT (ie, ASCT was the last treatment). 1682 (61%) patients received induction therapy as frontline treatment, of whom 187 (11%) also received consolidation therapy. The latter group was younger than those who received only induction therapy, had lower mean CCI scores, and comparable or lower incidences of selected comorbidities. The most common frontline therapy for non-transplant and transplant-eligible patients was bortezomib/dexamethasone and bortezomib/lenalidomide/dexamethasone, respectively. Attrition rates across all LOTs were high for non-transplant patients (range, 43–57%) and transplant patients (range, 21–37%). Treatment duration decreased by LOT for non-transplant patients and was consistent across LOTs for transplant patients. Conclusions: In this analysis, a substantial proportion of patients with NDMM who received frontline therapy did not appear to receive a subsequent LOT. These high attrition rates underscore the need to use the most optimal treatment regimens upfront rather than reserving them for later LOTs in which the clinical benefit may decrease.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12885-020-07503-y

Cites

20 of 20 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Challenges in treating relapsed/refractory multiple myeloma are compounded by limited effective salvage treatment options and high attrition.

    “Challenges are compounded by limited effective salvage treatment options3 and high attrition.4”

    From Teclistamab plus Daratumumab in Relapsed or Refractory Multiple Myeloma (2026) · cites this paper as [4]

  • High treatment attrition is such that only 13 to 35% of patients receive four or more lines of therapy.

    “High treatment attrition - only 13 to 35% of patients receive four or more lines of therapy - also highlights the need to use effective therapies early. 9”

    From Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma. (2023) · cites this paper as [9]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Fonseca, R., Usmani, S. Z., Mehra, M., Slavcev, M., He, J., Cote, S., Lam, A., Ukropec, J., Maiese, E. M., Nair, S., Potluri, R., & Voorhees, P. M.
Affiliations
  • Levine Cancer Institute (US)
  • Janssen Scientific Affairs (United States) (US)
  • Janssen (Belgium) (BE)
ORCID
Venue
BMC Cancer
Publisher
Springer Science and Business Media LLC
Published
2020-11-10
Volume
20
Issue
1
Pages
1087-1087
ISSN
1471-2407 (ISSN-L)
DOI
10.1186/s12885-020-07503-y
PMC
PMC7656738
OpenAlex
W3098371200
Cited by
127
References
20
Citations by year
2026: 21 · 2025: 33 · 2024: 26 · 2023: 25 · 2022: 16 · 2021: 5
FWCI
7.26
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Cancer (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Janssen Global Services, LLC
Topics
  • Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
  • Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Amyloidosis: Diagnosis, Treatment, Outcomes
Keywords
multiple myeloma, newly diagnosed multiple myeloma, attrition rates, treatment lines, autologous stem cell transplantation, induction therapy, consolidation therapy, bortezomib, lenalidomide, dexamethasone, comorbidities, treatment duration, treatment toxicity, transplant eligibility, medication adherence
MeSH terms
Bortezomib, Lenalidomide, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Combined Modality Therapy, Dexamethasone, Female, Follow-Up Studies, Humans, Male, Multiple Myeloma, Patient Dropouts, Prognosis, Retrospective Studies, Transplantation, Autologous, Survival Rate, Hematopoietic Stem Cell Transplantation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review