A clearer understanding of the prognostic implications of t(11;14) in multiple myeloma (MM) is needed to inform current and future therapeutic options. We utilized real-world data from a US database to examine treatment patterns and outcomes in patients by t(11;14) status compared with high- and standard-risk subgroups across different lines of therapy (LoT). This retrospective, observational cohort study used de-identified patient-level information from adults with MM and first-line treatment initiation between January 2011 and January 2020, followed until February 2020. The high-risk cohort comprised patients with high-risk genetic abnormalities per mSMART criteria (including those with co-occurring t(11;14)). Among 6138 eligible patients, 6137, 3160, and 1654 received first-, second-, and third-line treatments, respectively. Of 645 patients who had t(11;14), 69.1% had t(11;14) alone, while 30.9% had co-occurring high-risk abnormalities. Altogether, 1624 and 2544 patients were classified as high- and standard-risk, respectively. In the absence of biomarker-driven therapy, treatment patterns remain similar across LoT in high-risk, t(11;14)+, and standard-risk subgroups. Across all LoT, patient outcomes in the high-risk subgroup were less favorable than those in the t(11;14)+ and standard-risk subgroups. Thus, there is an opportunity for novel therapeutics targeted to t(11;14) and other defined subgroups to personalize MM therapy and optimize patient outcomes.
为明确t(11;14)在多发性骨髓瘤（MM）中的预后意义以指导当前及未来的治疗选择，我们利用美国数据库的真实世界数据，对比不同治疗线数（LoT）中t(11;14)患者与高危、标危亚组的治疗模式及结局。这项回顾性观察性队列研究使用2011年1月至2020年1月期间开始一线治疗、随访至2020年2月的MM成年患者的去身份化个体数据。高危队列包含符合mSMART标准的高危遗传异常患者（包括同时存在t(11;14)者）。在6138例符合条件患者中，分别有6137例、3160例和1654例接受了一线、二线和三线治疗。在645例携带t(11;14)的患者中，69.1%为单纯t(11;14)，30.9%同时存在高危异常。总体而言，1624例和2544例患者分别被归类为高危和标危亚组。在缺乏生物标志物驱动治疗的情况下，各治疗线数中高危、t(11;14)阳性及标危亚组的治疗模式保持相似。在所有治疗线数中，高危亚组患者的临床结局均逊于t(11;14)阳性及标危亚组。因此，针对t(11;14)及其他明确亚组开发新型疗法，将有助于实现MM个体化治疗并优化患者预后。
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