Development of a prognostic model for overall survival in multiple myeloma using the Connect® MM Patient Registry

• Published in: British journal of haematology Vol. 187; no. 5; pp. 602 - 614
• Main Authors: Terebelo, Howard R., Abonour, Rafat, Gasparetto, Cristina J., Toomey, Kathleen, Durie, Brian G. M., Hardin, James W., Jagannath, Sundar, Wagner, Lynne, Narang, Mohit, Flick, E. Dawn, Srinivasan, Shankar, Yue, Lihua, Kitali, Amani, Agarwal, Amit, Rifkin, Robert M.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.12.2019; John Wiley and Sons Inc
• Subjects: Clinical trials; Creatinine; Diabetes mellitus; Haematological Malignancy; Hematology; matrix; Medical prognosis; Multiple myeloma; myeloma; Oncology; Patients; Plasmacytoma; prognosis; registry; Research Paper; Survival; registry; myeloma; matrix; prognosis; survival
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1111/bjh.16139

Summary Median overall survival (OS) has improved for patients with newly diagnosed multiple myeloma (NDMM), but prognosis varies depending on baseline patient characteristics. Current models use data from selected clinical trial populations, which prevent application to patients in an unselected community setting that reflects routine clinical practice. Using data from the Connect® MM Registry, a large, US, multicentre, prospective observational cohort study (Cohort 1: 2009–2011; Cohort 2: 2012–2016) of 3011 patients with NDMM, we identified prognostic variables for OS via the multivariable analysis of baseline patient characteristics in Cohort 1 (n = 1493) and developed a tool to examine individual outcomes. Factors associated with OS (n = 1450 treated patients; P < 0·05) were age, del(17p), triplet therapy use, EQ‐5D mobility, International Staging System stage, solitary plasmacytoma, history of diabetes, platelet count, Eastern Cooperative Oncology Group performance status and serum creatinine, which were used to create survival matrices for 3‐ and 5‐year OS. The model was internally and externally validated using Connect MM Cohort 2 (Harrell's concordance index, 0·698), MM‐015 (0·649), and the phase 3 FIRST (0·647) clinical trials. This novel prognostic tool may help inform outcomes for NDMM in the era of triplet therapy use with novel agents.