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Aya-Myeloma: Real World, Single Center Experience Over Last 5 Years
Abstracts apoptosis in MM cells. These preliminary results suggested that REIIBP is a HMTase and might act as an oncoprotein in t(4;14) MM cells.
PS-096 Aya-Myeloma: Real World, Single Center Experience Over Last 5 Years
PS-097 Treatment Patterns and Outcomes in Clinical Practice Among Patients with Newly-Diagnosed Multiple Myeloma: Systematic Literature Review Candice Yong,1 Huamao Mark Lin,1 Aleksandra Gara,2 Katherine Osenenko,2 Ellen Korol,2 Juliette Thompson,3 Katarina Luptakova,1 Brian Seal1
Uday Yanamandra,1 Neha Saini,2 Alka Khadwal,3 Gaurav Prakash,3 Deeepesh Lad,4 Neelam Varma,3 Subhash Varma,3 Pankaj Malhotra3
Takeda Pharmaceutical Company Ltd., Cambridge, MA; 2ICON plc.,
1
Vancouver, British Columbia; 3ICON plc., Abingdon, Oxon
PGIMER, Chandigarh, Chandigarh; 2PGIMER, India; 3PGIMER;
1
Millennium Pharmaceuticals Inc., a wholly owned subsidiary of
4
PGIMER, Chandigarh, Chandigarh
Introduction: Multiple myeloma (MM) is considered as a disease of the old with the reported median age of 60-70 years. The disease occurs a decade earlier in the Indian subcontinent as compared to the West with a median age ranging from 45-50y in different series. It is very uncommon for MM to affect adolescents and young adult (AYA) with limited literature on the subject. Aim: The purpose of this study was to analyze the disease characteristics and outcomes of the AYA-MM in the real world setting. Patients and methods: It is a retrospective single center study conducted at a tertiary care center from North India. Records of all consecutive patients with AYAMM (15-39y of age) who were managed from 01 Jan 2010 to 31 Dec 2015 were reviewed. Survival was assessed from the date of start of treatment to the last follow-up date or death due to any cause. Results: A total of 415 patients managed for MM in the last 5 years were included in the study. The frequency of the AYA-MM was 9.6% (40/415) of whom five patients were younger than 30y. There was male preponderance with a male: female ratio of (26:14; ratio1.85). The median age of the patients was 38y (mean-36.025, 1839.9, SD e 4.67). The main presenting features were bone pain (55%), fatigue (45%), extramedullary plasmacytomas (20%) and infections (12%). The mean duration from symptom onset to diagnosis was 269d (median e 122, 15-1503, SD e 382). Organomegaly was seen in 28% (hepatomegaly in 27%, splenomegaly 12%). The performance status of the patients was good (ECOG>2 e 24%). Hypercalcemia, renal impairment (eGFR<60ml/min/ 1.73m2), anemia and lytic lesions were seen in 27.7%, 31.6%, 63.15% and 56.25% of patients respectively. 77.8% patients had abnormal k/l ratio, 61.12% patients had raised M protein and only 4 patients had Bence Jones proteinuria. Amyloid was absent in all evaluable cases except one. On risk stratification, 25%, 50%, and 75% patients were in ISS I, II and III respectively. Only 22.5% patients were transplanted (all Auto SCT), whereas most of the patients were managed with the chemotherapy even after remission induction (77.5%). The median survival after diagnosis was 388d (11-2170 days; mean - 561510d). The 3y median survival of the study population is 80.21%. Conclusion: AYA-MM patients have a higher prevalence of extramedullary disease, high-risk disease, but longer survival than that observed in series of all ages.
e54
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16th International Myeloma Workshop March 1-4, 2017
Novel agents (proteasome inhibitors [PIs], immunomodulatory agents [IMiDs]) improve disease control and survival rates in patients with newly diagnosed multiple myeloma (NDMM) compared to conventional chemotherapy. Results from clinical trials may not reflect outcomes in the real world. The objective was to summarize published data on treatment patterns and outcomes in clinical practice among patients with NDMM. Methods: A systematic literature review of observational studies of NDMM treatment patterns and clinical outcomes was conducted. Published literature was searched from Jan 2010-Jun 2016 using Medline, Embase, and PubMed databases; select conferences between 2014-2016 were also reviewed. Eligibility included studies of patients with NDMM (n50) receiving first-line treatment. Results: Included studies (n¼107) were conducted in Europe (35%), Canada or US (31%), Asia Pacific (26%), Latin America (4%), and multi-national (3%). Most studies (88%) were retrospective. Of 82 studies reporting treatment type, 95% included novel agent regimens: 82% and 83% of studies reported PI or IMiD use, respectively. The percentage of patients receiving novel agents ranged from 3% (diagnosis [dx] year 1999, US) to 83% (dx years 2009-2013, Denmark), and varied by country and patient characteristics. Proportions of patients receiving triplet regimens increased with time, likely associated with the introduction of novel agents (0% [dx years 1995-2005] - 12% [dx years 2006-2014]). Median (Mdn) treatment duration ranged from 3.4-23 months (mo), although few studies reported this (16%). Clinical outcomes (overall survival [OS], progression-free survival [PFS], overall response rate [ORR]) were reported in 92 studies. Consistently, patients receiving a PI or IMiD had longer OS than conventional chemotherapy. The minimum Mdn OS reported was 6 mo in patients with high-risk cytogenetics not treated with a PI, while 7 studies reported Mdn OS was not reached (NR, Mdn follow-up [f/u] 23-71 mo; f/u not reported in 2 studies) in patients treated with novel agents or stem cell transplant (SCT). Mdn PFS ranged from 7 mo in SCT-ineligible patients with no response to first-line novel agent treatment, to NR in patients treated with firstline PI-based triplet regimens (Mdn f/u: 23-43 mo). ORR ranged from 31% in those with high-risk cyotgenetics treated with novel agents to >90% in those receiving PI or IMiD triplet regimens or SCT. Conclusions: As targeted NDMM therapies have become
PS-096 Aya-Myeloma: Real World, Single Center Experience Over Last 5 Years
PS-097 Treatment Patterns and Outcomes in Clinical Practice Among Patients with Newly-Diagnosed Multiple Myeloma: Systematic Literature Review Candice Yong,1 Huamao Mark Lin,1 Aleksandra Gara,2 Katherine Osenenko,2 Ellen Korol,2 Juliette Thompson,3 Katarina Luptakova,1 Brian Seal1
Uday Yanamandra,1 Neha Saini,2 Alka Khadwal,3 Gaurav Prakash,3 Deeepesh Lad,4 Neelam Varma,3 Subhash Varma,3 Pankaj Malhotra3
Takeda Pharmaceutical Company Ltd., Cambridge, MA; 2ICON plc.,
1
Vancouver, British Columbia; 3ICON plc., Abingdon, Oxon
PGIMER, Chandigarh, Chandigarh; 2PGIMER, India; 3PGIMER;
1
Millennium Pharmaceuticals Inc., a wholly owned subsidiary of
4
PGIMER, Chandigarh, Chandigarh
Introduction: Multiple myeloma (MM) is considered as a disease of the old with the reported median age of 60-70 years. The disease occurs a decade earlier in the Indian subcontinent as compared to the West with a median age ranging from 45-50y in different series. It is very uncommon for MM to affect adolescents and young adult (AYA) with limited literature on the subject. Aim: The purpose of this study was to analyze the disease characteristics and outcomes of the AYA-MM in the real world setting. Patients and methods: It is a retrospective single center study conducted at a tertiary care center from North India. Records of all consecutive patients with AYAMM (15-39y of age) who were managed from 01 Jan 2010 to 31 Dec 2015 were reviewed. Survival was assessed from the date of start of treatment to the last follow-up date or death due to any cause. Results: A total of 415 patients managed for MM in the last 5 years were included in the study. The frequency of the AYA-MM was 9.6% (40/415) of whom five patients were younger than 30y. There was male preponderance with a male: female ratio of (26:14; ratio1.85). The median age of the patients was 38y (mean-36.025, 1839.9, SD e 4.67). The main presenting features were bone pain (55%), fatigue (45%), extramedullary plasmacytomas (20%) and infections (12%). The mean duration from symptom onset to diagnosis was 269d (median e 122, 15-1503, SD e 382). Organomegaly was seen in 28% (hepatomegaly in 27%, splenomegaly 12%). The performance status of the patients was good (ECOG>2 e 24%). Hypercalcemia, renal impairment (eGFR<60ml/min/ 1.73m2), anemia and lytic lesions were seen in 27.7%, 31.6%, 63.15% and 56.25% of patients respectively. 77.8% patients had abnormal k/l ratio, 61.12% patients had raised M protein and only 4 patients had Bence Jones proteinuria. Amyloid was absent in all evaluable cases except one. On risk stratification, 25%, 50%, and 75% patients were in ISS I, II and III respectively. Only 22.5% patients were transplanted (all Auto SCT), whereas most of the patients were managed with the chemotherapy even after remission induction (77.5%). The median survival after diagnosis was 388d (11-2170 days; mean - 561510d). The 3y median survival of the study population is 80.21%. Conclusion: AYA-MM patients have a higher prevalence of extramedullary disease, high-risk disease, but longer survival than that observed in series of all ages.
e54
-
16th International Myeloma Workshop March 1-4, 2017
Novel agents (proteasome inhibitors [PIs], immunomodulatory agents [IMiDs]) improve disease control and survival rates in patients with newly diagnosed multiple myeloma (NDMM) compared to conventional chemotherapy. Results from clinical trials may not reflect outcomes in the real world. The objective was to summarize published data on treatment patterns and outcomes in clinical practice among patients with NDMM. Methods: A systematic literature review of observational studies of NDMM treatment patterns and clinical outcomes was conducted. Published literature was searched from Jan 2010-Jun 2016 using Medline, Embase, and PubMed databases; select conferences between 2014-2016 were also reviewed. Eligibility included studies of patients with NDMM (n50) receiving first-line treatment. Results: Included studies (n¼107) were conducted in Europe (35%), Canada or US (31%), Asia Pacific (26%), Latin America (4%), and multi-national (3%). Most studies (88%) were retrospective. Of 82 studies reporting treatment type, 95% included novel agent regimens: 82% and 83% of studies reported PI or IMiD use, respectively. The percentage of patients receiving novel agents ranged from 3% (diagnosis [dx] year 1999, US) to 83% (dx years 2009-2013, Denmark), and varied by country and patient characteristics. Proportions of patients receiving triplet regimens increased with time, likely associated with the introduction of novel agents (0% [dx years 1995-2005] - 12% [dx years 2006-2014]). Median (Mdn) treatment duration ranged from 3.4-23 months (mo), although few studies reported this (16%). Clinical outcomes (overall survival [OS], progression-free survival [PFS], overall response rate [ORR]) were reported in 92 studies. Consistently, patients receiving a PI or IMiD had longer OS than conventional chemotherapy. The minimum Mdn OS reported was 6 mo in patients with high-risk cytogenetics not treated with a PI, while 7 studies reported Mdn OS was not reached (NR, Mdn follow-up [f/u] 23-71 mo; f/u not reported in 2 studies) in patients treated with novel agents or stem cell transplant (SCT). Mdn PFS ranged from 7 mo in SCT-ineligible patients with no response to first-line novel agent treatment, to NR in patients treated with firstline PI-based triplet regimens (Mdn f/u: 23-43 mo). ORR ranged from 31% in those with high-risk cyotgenetics treated with novel agents to >90% in those receiving PI or IMiD triplet regimens or SCT. Conclusions: As targeted NDMM therapies have become