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e19535 Background: New Tx options have become available on the market or as investigational agents in Canada for relapsed/refractory MM in the last few years. These new Tx options include IMiDs [thalidomide, lenalidomide (Revlimid)] and a proteosome inhibitor [bortezomib (Velcade)]. These new agents are changing both the Tx patterns as well as the clinical outcome of this disease. New combination regimens of both new agents and older generic drugs are also being investigated. Methods: This retrospective analysis included all relapsed/refractory MM Pts who initiated drug Tx between Jul-06 and Jun-07 at Princess Margaret Hospital, Toronto, ON. Historical data collection focused on prior Tx (types), duration and efficacy. Results: This analysis included all prior historical Tx data Dec-96 to Jul-07) from 151 Pts. 62% of Pts were male. Time from diagnosis to 1st initial Tx was 1.7 (SD±4.2) months. Of the 25 Pts who had cytogenetics analyzed by FISH, 6 Pts had deletion 13q, 4 Pts had translocation involving chromosome 14 [including partner gene translocations on chromosomes 4 (2 Pts) and 11 (1 Pt)] and no Pts had deletion p53. 76.8% of Pts received at least 1 stem cell transplant (SCT) with 7.9% of Pts receiving 2 SCTs prior to current study Tx. Historical 1st line & 2nd line Txs, respectively, were cyclophosphamide ± steroid (14.6%, 28.3%), IMiD-based (17.2%, 40.2%), melphalan + prednisone (14.6%, 9.8%), vincristine + adriamycin + dex (69.5%, 5.4%), steroid monotherapy (23.8%, 22.8%), bortezomib based (0.7%, 15.2%), and other (6.0%, 6.5%). Overall best RRs (≥MR) during historical 1st & 2nd line Tx were 92.6% and 83.3% (≥ minimal response), respectively, with a corresponding 15.6% & 11.9% combined CR + near CR rate, respectively, across all regimens reported. Historical median TTP following 1st, 2nd, and 3rd line of Tx were 21.5 (95% CI: 18.9, 24.3), 20.2 (95% CI: 16.9, 22.8), and 10.0 (95% CI: 5.5, 16.6) months, respectively. Conclusions: This is the first known historical analysis of real world MM Txs in Canada from a large tertiary centre. Historical data suggests the common use of older drugs such as alkylating agents. This usage pattern may be different than in other countries where the accessibility of newer agents to treat MM is easier than in Canada. [Table: see text]

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e19503 Background: New Tx options, including IMiDs [thalidomide, lenalidomide (Revlimid)] and bortezomib (Bz) (Velcade), have in the last few years become available on the market or as investigational agents in Canada for relapsed or refractory MM. These new agents are changing the Tx pattern and the clinical outcome of this disease. Methods: This retrospective chart review included all relapsed/refractory MM Pts who initiated drug Tx between Jul-06 and Jun-07 inclusive at Princess Margaret Hospital, Toronto, ON. Results: A total of 151 Pts were treated for relapsed/refractory MM between Jul-06 & Jun-07. 57 Pts (40 receiving IMiD, 14 Bz, 3 other) were on clinical trials and thus not included in the analysis due to proprietary restrictions. Mean age, % male and BSA was 64.8 (SD±9.5) yrs, 68.1%, 1.9 (SD±0.2), respectively. Time from diagnosis to current therapy was 46.3 (SD±24.7) months. Nearly half the Pts were receiving treatment for 1st disease relapse (48.9%), 24.5% for 2nd relapse, 14.9% for 3rd relapse, and the remainder for ≥ 4th relapse. 74.5% of Pts had received at least 1 stem SCT prior to current study Tx. Current Txs included cyclophosphamide ± steroid (36.2%), Bz-based (26.6%), IMiD-based [17.0% (thalidomide only)], steroid monotherapy (13.8%), melphalan + prednisone (1.1%) and other (5.3%). Overall best RR was 43.6%, and 41.5% of Pts experienced PD up to the follow-up period. Mean TTP was 9.6 (SE±0.5) months. 30.9% of Pts received ESAs, 12.8% of Pts required RBC or platelet transfusion, 6.4% of Pts received G-CSF, and 47.9% of Pts received supportive pain medication. 27.7% of Pts required unscheduled hospitalization (56.4% due to MM and 7.7% due to Tx). Incidence of any grade drug-related varicella zoster, increased neuropathic pain, and thromboembolic events were 6.4%, 16.0%, 2.1%, respectively. Four Pts died while on current Tx and 14 died during the follow-up period of up to Dec-07. Conclusions: Bz was rarely used prior to public funding in Jul-06. Since then Bz (either as monotherapy or in combination) is the most commonly used novel Tx outside a clinical study and is replacing the use of the older agents. As the first analysis of current real world MM Txs in Canada from a large tertiary academic centre, this data is reflective of emerging treatment trends. [Table: see text]