Background: The survival of newly diagnosed multiple myeloma (NDMM) has improved markedly worldwide with the introduction of proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and anti-CD38 monoclonal antibodies. However, real-world progress among Chinese patients remains underexplored. This study evaluated 20-year survival trends in patients with NDMM treated in our institute and benchmarked them against outcomes from the Flatiron Health database in the United States.Patients and methods: Consecutive adults diagnosed with NDMM in our institute between 2003 and 2023 were retrospectively analyzed. U.S. patients were identified from the Flatiron Health database using similar inclusion criteria. Clinical characteristics, first-line regimens, and autologous stem cell transplantation (ASCT) rates were summarized. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan–Meier methods.Results: Among 1622 Chinese and 12,582 US patients, median age was 57 vs. 68 years. The median PFS and OS of NDMM patients in our institute was 40.1 months and 99.6 months, respectively. Induction therapy in the NICHE cohort changed markedly from primarily chemo-based therapy to combined PIs + IMIDs-based treatment, whereas these treatments were used much earlier in Flatiron. Uptake of new therapies in China increased rapidly after their inclusion in national health insurance. ASCT utilization was higher overall in China (34.9% vs. 22.1%) but remained lower among patients >65 years (6.7% vs. 12.1%).Conclusions: Two decades of real-world data from a major Chinese myeloma center demonstrate substantial improvements in survival and modernization of NDMM treatment, while highlighting persistent disparities amongst older adults.
背景：随着蛋白酶体抑制剂（PIs）、免疫调节药物（IMiDs）和抗CD38单克隆抗体的应用，全球范围内新诊断多发性骨髓瘤（NDMM）患者的生存率已显著提高。然而，中国患者的真实世界生存进展仍缺乏充分研究。本研究评估了我院2003年至2023年间收治的NDMM患者20年生存趋势，并与美国Flatiron Health数据库的结局进行了比较。 患者与方法：回顾性分析2003年至2023年间在我院连续确诊的NDMM成年患者。美国患者通过Flatiron Health数据库采用相似的纳入标准进行筛选。总结临床特征、一线治疗方案及自体干细胞移植（ASCT）应用率。采用Kaplan-Meier法评估总生存期（OS）和无进展生存期（PFS）。 结果：在1622例中国患者和12582例美国患者中，中位年龄分别为57岁和68岁。我院NDMM患者的中位PFS和OS分别为40.1个月和99.6个月。中国队列的诱导治疗从以化疗为主显著转变为以PIs联合IMiDs为基础的方案，而美国队列中此类方案的应用时间更早。中国在新药纳入国家医保后，其使用率迅速提升。中国患者的ASCT总体应用率更高（34.9% vs. 22.1%），但在65岁以上患者中仍较低（6.7% vs. 12.1%）。 结论：来自中国主要骨髓瘤中心的二十年真实世界数据显示，NDMM患者的生存结局显著改善，治疗模式日趋现代化，但同时也凸显了老年患者群体中持续存在的治疗差异。
肿瘤(癌症)患者之家