New Treatments Needed for Patients With Triple-Class Refractory Multiple Myeloma


Patients with triple-class refractory multiple myeloma (TCR MM) experienced poor survival, significant hospitalizations, and a clinically meaningful decline in health-related quality of life (HRQoL), according to data from the Connect MM Disease Registry presented at the American Society of Hematology’s 2021 Annual Meeting and Exposition. The study demonstrates a need for novel tolerable and efficacious therapeutic agents to address the burden of illness in patients with MM, according to the investigators.

“Treatment resistance remains a challenge for most multiple myeloma patients and their outcomes and health-related quality of life worsens with each line of therapy,” said Robert Rifkin, MD, medical director of biosimilars for McKesson, associate chair of hematology research and myeloma disease lead for The US Oncology Network, and hematologist with Rocky Mountain Cancer Centers, in a press release. “Patients who are refractory to immunomodulatory drugs, proteasome inhibitors and anti-CD38 antibodies, or triple-class refractory, have an especially bleak prognosis and high disease burden.”

Treatment resistance is a common challenge faced by most patients with MM during the course of their disease. Patients with MM who are refractory to immunomodulatory drugs, proteasome inhibitors, and anti-CD38 antibodies have a poor prognosis, with the holistic burden being poorly understood, according to the researchers.

To conduct the study, investigators gathered data between September 28, 2009, and February 4, 2021. Eligible participants included patients 18 years of age or older at their first documented diagnosis of MM, which became TCR during their disease course. The International Myeloma Working Group Criteria was used to determine whether the patient’s disease was refractory.

The analysis included 240 patients with a mean age at index date of 68.1 years and a mean time since initial diagnosis of 64.1 months. Among study participants, 63.3% had received prior stem cell transplantation.

For all patients, median overall survival (OS) was 8.9 months, whereas OS for participants who received more than 4 prior lines of therapy was 8 months. Analysis of HRQoL demonstrated a clinically meaningful decline in HRQoL from baseline following the index date based on the EQ-5D utility index, EQ-5D VAS, and FACT-G total score.


Tang D, Hari P, Ramasamy K, et al. Real-world treatment patterns and clinical, economic, and humanistic burden in triple-class refractory multiple myeloma: Analysis of the Connect® Multiple Myeloma (MM) Disease Registry. Presented at: ASH Annual Meeting and Exposition 2021. Accessed December 10, 2021.

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