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Incidence and reasons for discontinuation of first-line therapy in patients with multiple myeloma: results from a historical cohort, Brazil 2009–2020

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Abstract

Multiple myeloma (MM) is an incurable hematological cancer requiring multiple lines of anti-myeloma regimens to promote disease remission and increase patient survival. The study assessed the incidence and reasons for discontinuation of first-line therapy in outpatients who started MM therapy in Belo Horizonte, Brazil from 2009 to 2020. A historical cohort study in which patients were followed from treatment initiation until discontinuation of first-line therapy. Discontinuation of first-line therapy was characterized as (i) discontinuation followed by a second-line therapy, and (ii) discontinuation that prevented patients from receiving a subsequent line of treatment. Non-parametric competing risk analysis with a 95% confidence interval estimated the cumulative incidences of discontinuation followed by a second-line therapy. The probability of discontinuation was compared according to selected variables using the Gray’s test at a significance level of 5%. Approximately half of the participants (n = 260) were female and younger than 65 years. Discontinuation of first-line therapy followed by a second-line therapy accounted for 50.4% of the patients and occurred up to 30th month. The main reason for discontinuation not qualifying patients for receiving second-line therapy was to achieve a response to treatment. The maximum times for discontinuation not followed by a second-line therapy ranged from 12 to 20 months due to deaths or response to treatment. The probability of receiving second-line therapy was higher among patients initiating therapy in 2009–2014 and those not undergoing transplantation. In conclusion, discontinuation of first-line therapy followed by second-line treatment occurred as likely as the discontinuation not followed by a subsequent line.

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No datasets were generated or analysed during the current study.

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Acknowledgements

We thank the staff of the participating centers for their collaboration.

Funding

The authors state that the study did not receive any funding.

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Authors and Affiliations

  1. Department of Social Pharmacy, Federal University of Minas Gerais - UFMG, Avenida Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, Brazil

    Marina Xavier Teixeira, Paula Lana de Miranda Drummond, Jéssica Soares Malta, Lívia Pena Silveira & Cristiane Aparecida Menezes de Pádua

  2. Department of Pharmaceutical Products, Federal University of Minas Gerais - UFMG, Belo Horizonte, Brazil

    Adriano Max Moreira Reis

  3. Ezequiel Dias Foundation - Funed, Belo Horizonte, Brazil

    Paula Lana de Miranda Drummond

  4. Hospital das Clínicas da UFMG, Belo Horizonte, Brazil

    Lívia Pena Silveira

Authors
  1. Marina Xavier Teixeira
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  2. Adriano Max Moreira Reis
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  3. Paula Lana de Miranda Drummond
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  4. Jéssica Soares Malta
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  5. Lívia Pena Silveira
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  6. Cristiane Aparecida Menezes de Pádua
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Contributions

MXT, AMMR and CAMP conceived and designed the study. MXT, JSM, LPS and PLMD contributed substantially to the data collection. CAMP and MXT performed the analysis and interpreted the data. All the authors contributed substantially to the draft of the manuscript. The final version of the manuscript was approved by all the authors.

Corresponding author

Correspondence to Cristiane Aparecida Menezes de Pádua.

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Teixeira, M.X., Reis, A.M.M., Drummond, P.L.d. et al. Incidence and reasons for discontinuation of first-line therapy in patients with multiple myeloma: results from a historical cohort, Brazil 2009–2020. Ann Hematol (2024). https://doi.org/10.1007/s00277-024-05684-1

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