Multiple myeloma: response to treatment and survival of patients according to the interim analysis of the Russian observational, retrospective-prospective, multicenter cohort study (MULTISPECT)

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Abstract

Aim. The primary objective of the interim analysis of the MULTISPECT study was to evaluate the short-term efficacy of the treatment and long-term outcomes in cohorts of primary and pretreated patients with multiple myeloma (MM) receiving treatment in actual clinical practice in various regions of the Russian Federation. Secondary objectives were a description of the main characteristics of patients; analysis of the most commonly used therapy regimens of the 1st and later lines and the sequence of their changes; evaluation of the response to therapy. Additional objectives included evaluation of the effect of the new COVID-19 coronavirus infection on the course of MM in patients.

Materials and methods. The study is an observational retrospective-prospective multicenter cohort study. For its implementation, a structured database of patients with MM was used, provided by hematologists of the centers affiliated for the study.

Results. The study included 1,294 patients (cohort 1 – 806, cohort 2 – 488). In both cohorts, patients aged 60–69 years were in the majority. 3 lines of therapy (L1, L2, L3) were used for cohort 1; in cohort 2, the 4th line of therapy was also used in 2 patients. The therapy regimens were analyzed for 290 (22.41%) of all patients in the study. Responses to therapy were analyzed for 214 patients of cohort 1 and 109 patients of cohort 2. Autologous and allogeneic hematopoietic stem cell transplantations were carried out for a limited proportion of patients in both cohorts. At the end of the study and upon presentation of its results, the status of patients was the following: 96% of patients in cohort 1 and 89% in cohort 2 were alive. The therapy regimens in both cohorts were characterized by variability. The most commonly used regimens in each of the lines of therapy have been identified. The most used therapy regimen in patients with MM of both cohorts was the VCD-regime. Rd-regime in cohort 1 and RD-regime in cohort 2 were the second most frequent used regimens. In patients of both cohorts, the therapy regimens including Bortezomib were most often used.

Conclusion. The variety of therapy regimens used to treat MM in actual clinical practice may be due to the factors of availability of new medicines and updated recommendations for the treatment of the disease. Further, in the context of this study, a more detailed analysis of the efficacy of certain therapy regimens in the 1st and later lines on progression free survival and overall survival of MM patients should be carried out.

About the authors

Vadim V. Ptushkin

Pirogov Russian National Research Medical University; Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology; Botkin City Clinical Hospital

Author for correspondence.
Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-9368-6050

д-р мед. наук, проф. каф. онкологии, гематологии и лучевой терапии; зав. отд. инновационных методов лечения подростков и взрослых; зам. глав. врача по гематологии; гл. внештат. специалист-гематолог Департамента здравоохранения г. Москвы

Russian Federation, Moscow; Moscow; Moscow

Michail A. Kunst

Republican Clinical Hospital; Kazan State Medical University

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-9721-8262

зав. отд-нием гематологии; ассистент каф. госпитальной терапии

Russian Federation, Kazan; Kazan

Tatiana A. Mitina

Vladimirsky Moscow Regional Research Clinical Institute

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0001-7493-0030

д-р мед. наук, вед. науч. сотр., зав. отд-нием клинической гематологии и иммунотерапии

Russian Federation, Moscow

Tatiana S. Konstantinova

Sverdlovsk Regional Clinical Hospital №1

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0003-4687-0784

канд. мед. наук, врач-гематолог высшей категории, зав. отд-нием

Russian Federation, Yekaterinburg

Natalia N. Rachkova

Bryansk Regional Hospital №1

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-9945-6993

гл. внештатный специалист, зам. глав. врача по мед. части, гематолог

Russian Federation, Bryansk

Tatiana V. Shelekhova

Razumovsky Saratov State Medical University

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-4737-7695

канд. мед. наук, проф., глав. врач Клиники гематологии и профпатологии

Russian Federation, Saratov

Ilya V. Elykomov

Regional Clinical Hospital

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-0406-9828

канд. мед. наук, зав. отд-нием; гл. гематолог края

Russian Federation, Barnaul

Galina B. Kuchma

Regional Clinic Hospital

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-2063-8859

канд. мед. наук, доц. каф. терапии, врач-гематолог

Russian Federation, Orenburg

Kiriena O. Farizova

Chelyabinsk Regional Clinical Hospital

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-7016-0750

врач-гематолог отд-ния гематологии

Russian Federation, Chelyabinsk

Olga Yu. Vinogradova

Pirogov Russian National Research Medical University; Botkin City Clinical Hospital

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-3669-0141

д-р мед. наук, проф. каф. гематологии, онкологии и лучевой терапии; зав. Московским городским гематологическим центром; врач-гематолог

Russian Federation, Moscow; Moscow

Eugene A. Nikitin

Botkin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0002-2490-1263

д-р мед. наук, проф., зав. дневным стационаром гематологии, онкологии и химиотерапии Московского городского гематологического центра; зав. каф. гематологии и трансфузиологии им. акад. И.А. Кассирского и А.И. Воробьева

Russian Federation, Moscow; Moscow

Evgeny D. Pashanov

Janssen, pharmaceutical companies of Johnson & Johnson, Medical Department

Email: vadimvadim@inbox.ru
ORCID iD: 0000-0003-0080-3367

д-р мед. наук, рук. терапевтического направления Гематология/Онкология

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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2. Fig. 1. Distribution of patients in cohort 1 by sex.

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3. Fig. 2. Distribution of patients in cohort 2 by sex.

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4. Fig. 3. The total distribution of patients in cohorts 1 and 2 by age at the date of inclusion in the study (%).

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5. Fig. 4. Age distribution of cohort 1 patients at enrollment date (%).

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6. Fig. 5. Age distribution of patients in cohort 2 at the date of inclusion in the study (%).

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7. Fig. 6. Distribution of patients in cohort 1 according to the ECOG scale in points at the time of inclusion in the study (%).

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8. Fig. 7. Distribution of patients in cohort 2 according to the ECOG scale in points at the time of inclusion in the study (%).

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9. Fig. 8. Number of SARS-CoV-2 cases detected in patients in both cohorts (%).

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10. Fig. 9. Number of autologous hematopoietic stem cell transplants performed (%) in cohort 1 patients with ECOG scores of 1 to 4.

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11. Fig. 10. Number of autologous hematopoietic stem cell transplants performed (%) in cohort 2 patients with ECOG scores of 1 to 4.

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12. Fig. 11. Survival rates of patients in cohort 1 (primary patients).

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13. Fig. 12. Survival rates of patients in cohort 2 (pretreated patients).

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14. Fig. 13. Survival of patients depending on the presence or absence of high-risk cytogenetic abnormalities.

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15. Fig. 14. Survival rates of patients in cohort 1 with confirmed presence or absence of soft tissue components.

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