Multiple myeloma treatment patterns and clinical outcomes in the Latin America Haemato‐Oncology (HOLA) Observational Study, 2008–2016

Summary Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008–2015 who init...

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Published in	British journal of haematology Vol. 188; no. 3; pp. 383 - 393
Main Authors	Hungria, Vania Tietsche, Martínez‐Baños, Deborah M., Peñafiel, Christian R., Miguel, Carlos E., Vela‐Ojeda, Jorge, Remaggi, Guillermina, Duarte, Fernando B., Cao, Carmen, Cugliari, Maria S., Santos, Telma, Machnicki, Gerardo, Fernandez, Mariana, Grings, Mariana, Ammann, Eric M., Lin, Jennifer H., Chen, Yen‐Wen, Wong, Yu‐Ning, Barreyro, Paula
Format	Journal Article
Language	English
Published	England Blackwell Publishing Ltd 01.02.2020 John Wiley and Sons Inc
Subjects	Adult Age Factors Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Autografts Bortezomib Bortezomib - administration & dosage Chemotherapy Clinical outcomes Comorbidity Drug Utilization - statistics & numerical data epidemiology Female Follow-Up Studies Haematological Malignancy ‐ Clinical Hematology Hematopoietic Stem Cell Transplantation - statistics & numerical data Humans Kaplan-Meier Estimate Latin America Latin America - epidemiology Male Medical records Middle Aged Multiple myeloma Multiple Myeloma - epidemiology Multiple Myeloma - therapy Observational studies Oncology Patients Practice Patterns, Physicians' - statistics & numerical data Private Facilities - statistics & numerical data progression‐free survival Public Facilities - statistics & numerical data Research Paper Retrospective Studies Stem cell transplantation Thalidomide Thalidomide - administration & dosage Treatment Outcome treatment patterns Latin America epidemiology multiple myeloma progression-free survival treatment patterns Latin America
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Abstract	Summary Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008–2015 who initiated first‐line therapy (LOT1). Of these patients, 33·9% underwent autologous stem cell transplantation (ASCT). During follow‐up, 501 (45·4%) and 129 (11·7%) patients initiated second‐ (LOT2) and third‐line therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide‐based therapy, from 66·7% to 42·6%, and chemotherapy from, 20·2% to 5·9%, whereas use of bortezomib‐based therapy or bortezomib + thalidomide increased from 10·7% to 45·5%. Bortezomib‐based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non‐ASCT and ASCT patients, median progression‐free survival (PFS) was 15·0 and 31·1 months following LOT1 and 10·9 and 9·5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib‐based or thalidomide‐based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America.
AbstractList	Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008–2015 who initiated first‐line therapy (LOT1). Of these patients, 33·9% underwent autologous stem cell transplantation (ASCT). During follow‐up, 501 (45·4%) and 129 (11·7%) patients initiated second‐ (LOT2) and third‐line therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide‐based therapy, from 66·7% to 42·6%, and chemotherapy from, 20·2% to 5·9%, whereas use of bortezomib‐based therapy or bortezomib + thalidomide increased from 10·7% to 45·5%. Bortezomib‐based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non‐ASCT and ASCT patients, median progression‐free survival (PFS) was 15·0 and 31·1 months following LOT1 and 10·9 and 9·5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib‐based or thalidomide‐based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America. Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008–2015 who initiated first‐line therapy (LOT1). Of these patients, 33·9% underwent autologous stem cell transplantation (ASCT). During follow‐up, 501 (45·4%) and 129 (11·7%) patients initiated second‐ (LOT2) and third‐line therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide‐based therapy, from 66·7% to 42·6%, and chemotherapy from, 20·2% to 5·9%, whereas use of bortezomib‐based therapy or bortezomib + thalidomide increased from 10·7% to 45·5%. Bortezomib‐based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non‐ASCT and ASCT patients, median progression‐free survival (PFS) was 15·0 and 31·1 months following LOT1 and 10·9 and 9·5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib‐based or thalidomide‐based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America. Summary Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008–2015 who initiated first‐line therapy (LOT1). Of these patients, 33·9% underwent autologous stem cell transplantation (ASCT). During follow‐up, 501 (45·4%) and 129 (11·7%) patients initiated second‐ (LOT2) and third‐line therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide‐based therapy, from 66·7% to 42·6%, and chemotherapy from, 20·2% to 5·9%, whereas use of bortezomib‐based therapy or bortezomib + thalidomide increased from 10·7% to 45·5%. Bortezomib‐based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non‐ASCT and ASCT patients, median progression‐free survival (PFS) was 15·0 and 31·1 months following LOT1 and 10·9 and 9·5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib‐based or thalidomide‐based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America. Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008-2015 who initiated first-line therapy (LOT1). Of these patients, 33·9% underwent autologous stem cell transplantation (ASCT). During follow-up, 501 (45·4%) and 129 (11·7%) patients initiated second- (LOT2) and third-line therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide-based therapy, from 66·7% to 42·6%, and chemotherapy from, 20·2% to 5·9%, whereas use of bortezomib-based therapy or bortezomib + thalidomide increased from 10·7% to 45·5%. Bortezomib-based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non-ASCT and ASCT patients, median progression-free survival (PFS) was 15·0 and 31·1 months following LOT1 and 10·9 and 9·5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib-based or thalidomide-based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America.Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008-2015 who initiated first-line therapy (LOT1). Of these patients, 33·9% underwent autologous stem cell transplantation (ASCT). During follow-up, 501 (45·4%) and 129 (11·7%) patients initiated second- (LOT2) and third-line therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide-based therapy, from 66·7% to 42·6%, and chemotherapy from, 20·2% to 5·9%, whereas use of bortezomib-based therapy or bortezomib + thalidomide increased from 10·7% to 45·5%. Bortezomib-based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non-ASCT and ASCT patients, median progression-free survival (PFS) was 15·0 and 31·1 months following LOT1 and 10·9 and 9·5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib-based or thalidomide-based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America. Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008-2015 who initiated first-line therapy (LOT1). Of these patients, 33·9% underwent autologous stem cell transplantation (ASCT). During follow-up, 501 (45·4%) and 129 (11·7%) patients initiated second- (LOT2) and third-line therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide-based therapy, from 66·7% to 42·6%, and chemotherapy from, 20·2% to 5·9%, whereas use of bortezomib-based therapy or bortezomib + thalidomide increased from 10·7% to 45·5%. Bortezomib-based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non-ASCT and ASCT patients, median progression-free survival (PFS) was 15·0 and 31·1 months following LOT1 and 10·9 and 9·5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib-based or thalidomide-based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America.
Author	Machnicki, Gerardo Grings, Mariana Ammann, Eric M. Fernandez, Mariana Santos, Telma Hungria, Vania Tietsche Miguel, Carlos E. Cugliari, Maria S. Vela‐Ojeda, Jorge Barreyro, Paula Lin, Jennifer H. Cao, Carmen Wong, Yu‐Ning Remaggi, Guillermina Peñafiel, Christian R. Martínez‐Baños, Deborah M. Duarte, Fernando B. Chen, Yen‐Wen
AuthorAffiliation	11 Janssen‐Cilag Farmacêutica Ltda. Buenos Aires Argentina 1 Santa Casa Medical School Sao Paulo Brazil 5 Centro Medico Nacional La Raza Mexico City Mexico 6 FUNDALEU Buenos Aires Argentina 7 Hospital Universitário Walter Cantídio Fortaleza Brazil 3 Hospital General de Mexico Mexico City Mexico 4 Fundacao Faculdade Regional de Medicina Sao Jose do Rio Preto Sao Jose do Rio Preto Brazil 2 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico 12 Janssen Scientific Affairs Titusville NJ USA 9 Instituto de Oncología Ángel H. Roffo Buenos Aires Argentina 8 Instituto Nacional del Cancer Santiago Chile 10 Janssen‐Cilag Farmacêutica Ltda. Sao Paulo Brazil
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Snippet	Summary Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study,... Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical...
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SubjectTerms	Adult Age Factors Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Autografts Bortezomib Bortezomib - administration & dosage Chemotherapy Clinical outcomes Comorbidity Drug Utilization - statistics & numerical data epidemiology Female Follow-Up Studies Haematological Malignancy ‐ Clinical Hematology Hematopoietic Stem Cell Transplantation - statistics & numerical data Humans Kaplan-Meier Estimate Latin America Latin America - epidemiology Male Medical records Middle Aged Multiple myeloma Multiple Myeloma - epidemiology Multiple Myeloma - therapy Observational studies Oncology Patients Practice Patterns, Physicians' - statistics & numerical data Private Facilities - statistics & numerical data progression‐free survival Public Facilities - statistics & numerical data Research Paper Retrospective Studies Stem cell transplantation Thalidomide Thalidomide - administration & dosage Treatment Outcome treatment patterns
Title	Multiple myeloma treatment patterns and clinical outcomes in the Latin America Haemato‐Oncology (HOLA) Observational Study, 2008–2016
URI	https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fbjh.16124 https://www.ncbi.nlm.nih.gov/pubmed/31392724 https://www.proquest.com/docview/2344379165 https://www.proquest.com/docview/2270019006 https://pubmed.ncbi.nlm.nih.gov/PMC7003731
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