Current treatment (Tx) patterns in relapsed or refractory multiple myeloma (MM): A retrospective chart review study
Bibliographic record
Abstract
e19503 Background: New Tx options, including IMiDs [thalidomide, lenalidomide (Revlimid)] and bortezomib (Bz) (Velcade), have in the last few years become available on the market or as investigational agents in Canada for relapsed or refractory MM. These new agents are changing the Tx pattern and the clinical outcome of this disease. Methods: This retrospective chart review included all relapsed/refractory MM Pts who initiated drug Tx between Jul-06 and Jun-07 inclusive at Princess Margaret Hospital, Toronto, ON. Results: A total of 151 Pts were treated for relapsed/refractory MM between Jul-06 & Jun-07. 57 Pts (40 receiving IMiD, 14 Bz, 3 other) were on clinical trials and thus not included in the analysis due to proprietary restrictions. Mean age, % male and BSA was 64.8 (SD±9.5) yrs, 68.1%, 1.9 (SD±0.2), respectively. Time from diagnosis to current therapy was 46.3 (SD±24.7) months. Nearly half the Pts were receiving treatment for 1st disease relapse (48.9%), 24.5% for 2nd relapse, 14.9% for 3rd relapse, and the remainder for ≥ 4th relapse. 74.5% of Pts had received at least 1 stem SCT prior to current study Tx. Current Txs included cyclophosphamide ± steroid (36.2%), Bz-based (26.6%), IMiD-based [17.0% (thalidomide only)], steroid monotherapy (13.8%), melphalan + prednisone (1.1%) and other (5.3%). Overall best RR was 43.6%, and 41.5% of Pts experienced PD up to the follow-up period. Mean TTP was 9.6 (SE±0.5) months. 30.9% of Pts received ESAs, 12.8% of Pts required RBC or platelet transfusion, 6.4% of Pts received G-CSF, and 47.9% of Pts received supportive pain medication. 27.7% of Pts required unscheduled hospitalization (56.4% due to MM and 7.7% due to Tx). Incidence of any grade drug-related varicella zoster, increased neuropathic pain, and thromboembolic events were 6.4%, 16.0%, 2.1%, respectively. Four Pts died while on current Tx and 14 died during the follow-up period of up to Dec-07. Conclusions: Bz was rarely used prior to public funding in Jul-06. Since then Bz (either as monotherapy or in combination) is the most commonly used novel Tx outside a clinical study and is replacing the use of the older agents. As the first analysis of current real world MM Txs in Canada from a large tertiary academic centre, this data is reflective of emerging treatment trends. [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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| 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".