Multiple Myeloma regimens significantly less effective in real-world treatment settings.

In this study, researchers looked at a large group of patients in a registry who received a series of drug combinations for treatment of multiple myeloma. The analysis included data from several thousand patients, and researchers assessed whether results from clinical trials were representative of what happens in the real world. The findings clearly indicate that is not the case with most regimens, with the exception of one — pomalidomide and dexamethasone. The results from the real-world setting showed inferior outcomes in terms of PFS and OS, and responses were similarly lower in the real world.

There are multiple reasons for this. Obviously, patients on clinical trials have to meet certain criteria to be enrolled. They must have a certain level of performance; their labs have to fit, and their age has to be appropriate. Therefore, they tend to have better outcomes.

We recently published real-world outcomes about our own patients in Targeted Oncology. They showed a median OS of almost 12 years, which is longer than any reported in the world, despite the fact that we included everybody. So, I think the results also depend on the quality of care that you get at different institutions or in different parts of the world. In general, though, real-world studies do tend to show inferior outcomes compared with clinical trial data.

Reference: Jew S, et al. Target Oncol. 2023;doi:10.1007/s11523-023-00990-6 James R. Berenson, MD Berenson Cancer Center