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PLoS One. 2018 Dec 5;13(12):e0208507. doi: 10.1371/journal.pone.0208507. eCollection 2018.

Real-world treatment outcomes in multiple myeloma: Multicenter registry results from Finland 2009-2013.

Author information

1
Turku University Hospital and University of Turku, Dept of Clinical Hematology, Turku, Finland.
2
University of Helsinki and Helsinki University Hospital Comprehensive Cancer Center, Department of Hematology, Helsinki, Finland.
3
Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
4
Satakunta Central Hospital, Pori, Finland.
5
Päijät-Hämeen Central Hospital, Lahti, Finland.
6
Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
7
Kainuu Joint Authority for Social and Health Care, Clinic of Internal Medicine, Kajaani, Finland.
8
Janssen Cilag AB, Solna, Sweden.
9
Janssen Cilag OY, Espoo, Finland.
10
Janssen Cilag NV, Beerse, Belgium.
11
Department of Mathematics, Stockholm University, SE, Stockholm, Sweden.
12
JB Medical Ltd, The Old Brickworks, Sudbury, Suffolk, United Kingdom.
13
Department of Medical Epidemiology and Biostatistics, Karolinska Instutitet, Stockholm, Sweden.

Abstract

Outcomes for patients with multiple myeloma (MM) have improved with the advent of novel therapies, however, real-world evidence of outcomes in clinical practice is scarce. We conducted a multi-center registry study to build a reliable picture of treatment and patient outcomes in Finland. The aim of this study was also to understand any methodological challenges in assessing treatment outcomes using disease registry data.

METHODS:

We carried out a retrospective, observational study using data from the national Finnish Hematology Registry (FHR) to provide real-world evidence of outcomes for all adult patients diagnosed with and treated for MM between 2009-2013 at one of the six regional hospitals, with at least six months of recorded follow-up. Patients were identified within the FHR by applying eligibility criteria of a diagnosis of MM and verifiable records of medical treatment and lines of treatment during the study period. Patients receiving allogenic stem cell transplantation were excluded from the cohort, as were individuals who only had monoclonal gammopathy of undetermined significance diagnosis and patients who had not initiated treatment during this period. Kaplan Meier curves were used to calculate overall survival and time to next treatment. Stratification was carried out by drug status (conventional/novel) and by autologous stem cell transplant (ASCT) status.

RESULTS:

A total of 321 patients met the inclusion criteria and were included in this study. Overall survival (OS) was longest in patients who received first-line novel therapy and ASCT (median not reached during 60-month follow-up) versus 46.2 months for novel first-line therapy without ASCT and 25.6 months for first-line conventional therapy without ASCT. Similarly, median time to next treatment were 33.9 months, 12.6 months and 7.8 months, respectively.

CONCLUSIONS:

The adoption of novel treatments in MM in Finland has had substantial impact on patient outcomes. Given the reality of complex treatment combinations for MM and relatively low patient numbers, assessing individual treatment effectiveness will require substantial cohort sizes and advanced, collaborative analytics on an international scale.

PMID:
30517181
PMCID:
PMC6281251
DOI:
10.1371/journal.pone.0208507
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

KR has been a member of Advisory Boards for Abbvie, Celgene, Janssen-Cilag and Takeda and has received fees to attend Congresses from Abbvie, Amgen, Celgene, Janssen-Cilag, Sanofi, Takeda. PA has been a member of Advisory Boards for Amgen, Celgene, Janssen and Takeda and has received fees to attend Congresses from Amgen, Bristol-Meyers-Squibb, Celgene, Janssen, Roche, Sanofi, Takeda and Teva. RS has received research funding from Amgen, BMS, Celgene, Janssen-Cilag and Takeda and honoraria from the same companies (Advisory Board and presentations). MP has received honoraria from Amgen, Celgene, Janssen-Cilag and Takeda (Advisory Board and presentations). HO does not have any competing interests. VT does not have any competing interests. MS does not have any competing interests. KK has received financial support from Jansen to collect data for this study and travel grants from Amgen, Shire and Sanofi Genzyme. TJ, MaP, FS, PCK and AL are employees of Janssen, the funder of this research. FW does not have any competing interests. TD is a Director of JB Medical and has worked with, and been funded by, other pharmaceutical companies in the field of hematological cancer. The funder Janssen provided support in the form of salaries for authors AL, PCK, TMJ, FS, MaP. This was a company sponsored study conducted in collaboration with the Finnish researchers, where both parties were involved in the study design, analysis and publication as per ICMJE standards. Data collection was carried out at the Finnish hospitals, with financial support from the funder. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Janssen funded JB Medical Ltd to provide medical writing support, TD is a paid employee of JB Medical and carried out the work. JB Medical did not have any additional role in the study design, data collection and analysis or decision to publish. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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