Descriptive Study of Current Routine Clinical Practice in the Management of Patients With Multiple Myeloma in Spain: CROMMAS Study

BACKGROUND: The therapeutic landscape of multiple myeloma (MM) has evolved substantially in recent years, with expanding treatment options and increasing complexity in managing both newly diagnosed and relapsed/refractory (R/R) patients. Given the limited real-world evidence, this study aimed to describe current clinical practice in MM based on the experiences of hematologists in Spain. PATIENTS AND METHODS: CROMMAS was a descriptive study based on aggregated data. A total of 23 hematologists from the public health system participated in the study and completed a 57-question survey on the current management of patients with MM in hematology departments in clinical practice. RESULTS: According to the hematologists' experience, the most commonly prescribed induction therapy combinations in patients eligible for autologous stem cell transplant (ASCT) were daratumumab (D), bortezomib (V), lenalidomide (R) and dexamethasone (d) (49.6%), followed by D, V, thalidomide (T) and d (23.5%), and VRd (20.0%). After ASCT performance, nearly all patients (97.8%) received maintenance therapy, mainly lenalidomide (77.0%) or combined with bortezomib (12.8%). For ASCT-ineligible patients, DRd (66.1%) was the most frequently prescribed first-line treatment combination, followed by D, V, melphalan (M), and prednisone (16.5%). Among R/R patients with lenalidomide refractoriness, isatuximab, carfilzomib (K), and d (58.3%) was the most prescribed combination for second-line treatment, followed by DVd (13.9%) and pomalidomide-based combinations (12.2%). CONCLUSION: This study offers an overview of current real-world management of newly diagnosed and R/R MM in Spain, at a time when new therapies are rapidly emerging, existing clinical guidelines are outdated, and current data are scarce.