A retrospective chart review study of relapsed or refractory multiple myeloma (MM) patients (Pts): A look into historical treatment (Tx) patterns
Bibliographic record
Abstract
e19535 Background: New Tx options have become available on the market or as investigational agents in Canada for relapsed/refractory MM in the last few years. These new Tx options include IMiDs [thalidomide, lenalidomide (Revlimid)] and a proteosome inhibitor [bortezomib (Velcade)]. These new agents are changing both the Tx patterns as well as the clinical outcome of this disease. New combination regimens of both new agents and older generic drugs are also being investigated. Methods: This retrospective analysis included all relapsed/refractory MM Pts who initiated drug Tx between Jul-06 and Jun-07 at Princess Margaret Hospital, Toronto, ON. Historical data collection focused on prior Tx (types), duration and efficacy. Results: This analysis included all prior historical Tx data Dec-96 to Jul-07) from 151 Pts. 62% of Pts were male. Time from diagnosis to 1st initial Tx was 1.7 (SD±4.2) months. Of the 25 Pts who had cytogenetics analyzed by FISH, 6 Pts had deletion 13q, 4 Pts had translocation involving chromosome 14 [including partner gene translocations on chromosomes 4 (2 Pts) and 11 (1 Pt)] and no Pts had deletion p53. 76.8% of Pts received at least 1 stem cell transplant (SCT) with 7.9% of Pts receiving 2 SCTs prior to current study Tx. Historical 1st line & 2nd line Txs, respectively, were cyclophosphamide ± steroid (14.6%, 28.3%), IMiD-based (17.2%, 40.2%), melphalan + prednisone (14.6%, 9.8%), vincristine + adriamycin + dex (69.5%, 5.4%), steroid monotherapy (23.8%, 22.8%), bortezomib based (0.7%, 15.2%), and other (6.0%, 6.5%). Overall best RRs (≥MR) during historical 1st & 2nd line Tx were 92.6% and 83.3% (≥ minimal response), respectively, with a corresponding 15.6% & 11.9% combined CR + near CR rate, respectively, across all regimens reported. Historical median TTP following 1st, 2nd, and 3rd line of Tx were 21.5 (95% CI: 18.9, 24.3), 20.2 (95% CI: 16.9, 22.8), and 10.0 (95% CI: 5.5, 16.6) months, respectively. Conclusions: This is the first known historical analysis of real world MM Txs in Canada from a large tertiary centre. Historical data suggests the common use of older drugs such as alkylating agents. This usage pattern may be different than in other countries where the accessibility of newer agents to treat MM is easier than in Canada. [Table: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".