Treatment landscape and disease burden of patients with multiple myeloma in Japan: a real-world survey

Multiple myeloma (MM) is a hematological malignancy associated with poor health-related quality of life (HRQoL). Safe and effective treatments for MM are limited. There is a need for real-world data to improve understanding of treatment patterns and sequencing in routine clinical practice in Japan. This study evaluated disease burden, treatment patterns, treatment sequencing, and reasons for treatment selection in patients with MM in Japan. This analysis used survey data of hematologists or hemato-oncologists and their adult patients with MM who received active treatment in a real-world setting in Japan between September 2022 and May 2023. Treatment and retreatment patterns and data from several validated patient reported outcome tools were analyzed. Formal sample size calculations were not applicable. Fifty-one physicians provided data for 309 patients, of whom 52 completed a quality-of-life survey (median [interquartile range] overall health status by EQ-5D-3L questionnaire: 0.7 [0.6–1.0]). Of 309 patients, most (77%) of the first-line cohort received a lenalidomide-based therapy. Lenalidomide retreatment was common in patients with relapsed/refractory MM (80%). Poor HRQoL and high retreatment rates indicate a need for new therapy options in patients with MM in Japan. These findings may guide healthcare policies and clinical practice in Japan. Many treatments, often in combinations, are being used to treat multiple myeloma, a type of blood cancer. In Japan, daratumumab and lenalidomide are common treatments for multiple myeloma. Sometimes, these treatments can stop working and the cancer worsens. This means that some patients need to be treated more than once. We wanted to understand what symptoms patients experienced when taking MM treatments, and at what stage of their illness and the treatment combinations they received. We used information from an independent survey of 51 doctors and 309 of their patients in Japan to better understand how multiple myeloma are treated and how treatments affect patients with this condition. Most patients were affected by symptoms of multiple myeloma, such as back pain, fatigue, and bone pain, and these symptoms affected their everyday lives. In many patients, the first treatment for their MM was a combination that included lenalidomide. Combination treatments that included daratumumab were used most often overall as a first treatment in patients who had started therapy at the time of data collection and used least often among patients who were receiving their fourth treatment. Patients whose cancer had worsened after a previous treatment were often given the same treatment again. These treatments sometimes do not work as well when they are used again. There is a need for developing new drugs that work in different ways, so that if a cancer comes back after a treatment, other treatment options are available.