医疗保健提供者与复发/难治性多发性骨髓瘤患者对治疗优先事项和新疗法的看法

With novel therapies including chimeric antigen receptor T-cell (CAR-T) therapy and bispecific antibodies (BsAbs), healthcare providers (HCPs) face complexities managing treatment for patients with relapsed/refractory multiple myeloma (RRMM). This study, among the largest surveys on RRMM, examined unmet needs in care access, barriers to novel therapy use, and treatment decision-making.

This survey-based study (March-June 2024) enrolled 2284 participants (patients: 1301; HCPs: 983) across 7 countries. Patients with >1 relapse/progression and HCPs managing 3 patients were included. Data were analyzed using descriptive statistics and 2 tests.

For patients, treatment priorities included slowing disease progression (second line [2L], 47%; third or later line [ 3L], 49%), minimizing adverse events (AEs; 2L, 43%; 3L, 49%), and extending life (2L, 39%; 3L, 38%). HCPs prioritized prolonging survival and controlling disease. Younger patients (<65 vs 65 years) prioritized convenience (40% vs 24%; P <0.01) and avoiding referrals to new institutions for therapies (32% vs 20%; P <0.01). Across geographies, HCPs reported logistical challenges as key reasons that CAR-T (38%) or BsAb (34%) therapy was not offered. Novel therapies were offered to patients more frequently in the US vs EU (CAR-T, 84% vs 77%, P =0.023; BsAbs, 84% vs 76%, P =0.011), with a similar trend in the US vs Japan for CAR-T; however, across all geographies, few patients recalled being offered CAR-T (17%) or BsAbs (13%). Patients receiving BsAbs prioritized efficacy-related reasons (25-35%) and nonclinical factors like less time and financial impact (27-29%), whereas those who received CAR-T prioritized patient success stories (50%), efficacy-related factors (48-50%), and minimal financial burden (43%).

This study revealed gaps in treatment priorities; patients valued quality of life and AE management, while HCPs focused on efficacy and delaying progression. There is a significant need to educate HCPs and patients on the impact of shared decision-making when considering novel treatments for RRMM.