Multiple myeloma treatment patterns and clinical outcomes in the Latin America Haemato‐Oncology (HOLA) Observational Study, 2008–2016

Abstract

Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008-2015 who initiated first-line therapy (LOT1). Of these patients, 33Á9% underwent autologous stem cell transplantation (ASCT). During follow-up, 501 (45Á4%) and 129 (11Á7%) patients initiated second-(LOT2) and thirdline therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide-based therapy, from 66Á7% to 42Á6%, and chemotherapy from, 20Á2% to 5Á9%, whereas use of bortezomib-based therapy or bortezomib + thalidomide increased from 10Á7% to 45Á5%. Bortezomib-based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non-ASCT and ASCT patients, median progression-free survival (PFS) was 15Á0 and 31Á1 months following LOT1 and 10Á9 and 9Á5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib-based or thalidomide-based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America.

Treatment pathways and disease journeys differ before and after introduction of novel agents in newly diagnosed multiple myeloma in Taiwan

“…Several analyses describing MM treatment in clinical practice have been published in recent years; most describe single or multi-center studies 8 – 11 , and real-world data on MM treatment patterns are not available in Asian countries. We used the NHIRD to describe treatment pathways for MM and linked this information to the Taiwan Death Registry, using progression through lines of treatment and mortality as indicators of disease progression after diagnosis.…”

Results of the daratumumab monotherapy early access treatment protocol in patients from Brazil with relapsed or refractory multiple myeloma

“…1 , 2 , 3 In Brazil and other Latin American countries, similar survival trends have been reported for patients with MM 4 ; however, access to new treatments may be delayed due to cost concerns or resource limitations. 5 , 6 The efficacy of MM treatment is substantially reduced following the first line of therapy, and progression-free survival (PFS) is poor among patients with relapsed or refractory MM (RRMM). 5 Access to novel therapies and improvement of outcomes among Latin American patients with RRMM remains an unmet need.…”

“… 5 , 6 The efficacy of MM treatment is substantially reduced following the first line of therapy, and progression-free survival (PFS) is poor among patients with relapsed or refractory MM (RRMM). 5 Access to novel therapies and improvement of outcomes among Latin American patients with RRMM remains an unmet need.…”

HOLA! from Latin America to the myeloma world

“…In this issue of the Journal, Hungria et al () present the results of a large multinational retrospective cohort study on 1103 Latin American patients with multiple myeloma (MM), diagnosed and treated in 30 institutions from 7 countries, including Brazil, Mexico, Argentina, Colombia, Panama and Chile. This is, to the best of my knowledge, the largest cohort of Latin American patients with MM to be reported in the medial literature, detailing patients’ characteristics, treatment patterns and outcomes to therapy.…”

“…I would like to focus on the treatment patterns of MM patients in Latin America, as Hungria et al () provide valuable insights on this topic, specifically in the aspect of access to treatment modalities. It is notable that only a third of the patients in this cohort underwent high‐dose chemotherapy followed by autologous stem cell transplantation (ASCT), especially with regard to a median age at diagnosis of 61 years, as I would have expected a larger proportion of patients undergoing ASCT.…”