Multiple myeloma (MM) is the second most common hematologic malignancy, accounting for 2% of cancer-related deaths in the United States and 1% globally. The treatment of MM can be very complex, and several new therapies have been developed that have improved outcomes in these patients. Not only have there been numerous approved therapies and combination regimens indicated for the inevitable patients who relapse or become refractory to therapy, but frontline therapy has also intensified.
At the 2022 European Society for Medical Oncology meeting, Kahlon and colleagues presented results from a retrospective study evaluating the trends of MM mortality and the correlation with the evolving treatment landscape through the past 45 years. The Surveillance, Epidemiology, and End Results (SEER) database was used for data collection, which represents approximately 48% of the US population aged >18 years from 22 regions. Long-term, age-adjusted, myeloma-specific mortality rates were studied in correlation with treatment patterns, reporting long-term mortality trends from 1975 to 2019 using the Annual Percent Change (APC) metric.
MM mortality increased from 1975 to 1993 (APC, 1.49%; P <.01), a period when there were no major treatment changes. Mortality decreased during 1993 to 2002 (APC, -0.49%; P <.01) after routine use of autologous stem-cell transplant was introduced as a frontline treatment in the mid-1990s. Between 2002 and 2009 (APC, -2.00%; P <.01) and 2012 and 2019 (APC, -1.61%; P <.01), more significant decreases were seen in mortality. The significant reduction from 2002 to 2009 can be correlated with the approval of proteasome inhibitors and immunomodulatory drugs. The continuation of this significant decrease from 2012 to 2019 can also be associated with approval of new agents since 2012, including monoclonal antibodies, and routine use of frontline triplet therapy and maintenance therapy since the mid-2010s. No significant change was seen from 2009 to 2012 (APC, 1.29%; P = .38), however.
Overall, decreasing MM mortality has been seen since the mid-1990s due to increasingly intensified frontline therapy and the approval of novel treatment options that have continued to evolve the treatment landscape.
Source
Kahlon NK, Abuhelwa Z, Sheikh T, et al. Multiple myeloma: effect of changing treatment landscape on population mortality in the US. Poster presented at: European Society for Medical Oncology; September 9-13, 2022; Paris, France.