The treatment landscape for relapsed multiple myeloma (MM) has increased. In this study, we aimed to characterize 2nd (n = 1439) and 3rd (n = 1104) line regimens and compare the results between subgroups based on the year of treatment initiation (2nd line: 2003–2008, 2009–2015, 2016–2021; 3rd line: 2004–2009, 2010–2015, and 2016–2021). In both the second- and third- lines, we observed increasing use of novel agents (from 78 to 95% and from 77 to 95%, respectively) and triplet regimens (from 15 to 69% and from 21 to 71%, respectively). The most frequently used regimens in the last studied periods included lenalidomide-dexamethasone (RD; 14%), carfilzomib-RD (12%), and daratumumab-RD (10%) for the second-line, and daratumumab-pomalidomide-dexamethasone (11%) and daratumumab-RD (10%) for the third-line. The median time to the next treatment from second-line therapy has improved from 10.4 months (95% CI: 8.4–12.4) to 16.6 months (95% CI: 13.3–20.3; p < 0.001). The median overall survival from the first relapse increased from 30.9 months (95% CI: 26.8–183.0) to 65.8 months (95% CI: 50.7–72.8; p < 0.001). Over the last two decades, more patients were treated with newer agents and triplets for relapsed MM. The landscape of regimens has become more diverse, and survival after the first relapse is continually improving.
复发多发性骨髓瘤（MM）的治疗选择日益增多。本研究旨在分析1439例二线治疗及1104例三线治疗方案的特征，并根据治疗起始年份对比亚组结果（二线：2003–2008年、2009–2015年、2016–2021年；三线：2004–2009年、2010–2015年、2016–2021年）。在二线与三线治疗中，新型药物的使用率（分别从78%升至95%及从77%升至95%）及三药联合方案的使用率（分别从15%升至69%及从21%升至71%）均呈现增长趋势。在最新研究阶段，最常用的二线方案包括来那度胺-地塞米松（RD；14%）、卡非佐米-RD（12%）和达雷妥尤单抗-RD（10%）；三线方案主要为达雷妥尤单抗-泊马度胺-地塞米松（11%）及达雷妥尤单抗-RD（10%）。二线治疗至下次治疗的中位时间从10.4个月（95% CI：8.4–12.4）延长至16.6个月（95% CI：13.3–20.3；p<0.001）。首次复发后的中位总生存期从30.9个月（95% CI：26.8–183.0）提升至65.8个月（95% CI：50.7–72.8；p<0.001）。近二十年来，更多复发多发性骨髓瘤患者接受了新型药物及三药联合治疗，治疗方案日趋多样化，首次复发后的生存状况持续改善。
Second- and third-line treatment strategies in multiple myeloma: a referral-center experience
肿瘤(癌症)患者之家