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Patients treated at an academic/National Cancer Institute Cancer Center (NCI-CC) for multiple myeloma (MM) had better survival rates. These findings were presented during the American Society of Hematology (ASH) 62nd Annual Meeting and Exposition.
Researchers from Yale University School of Medicine selected data from the Surveillance, Epidemiology and End Results (SEER)-Medicare database for 4932 patients with MM diagnosed between 2007 and 2015 who were covered by Medicare fee-for-service. Treatments through 2016 at differing care provider settings were assessed.
Patients were aged 75 years and older (51%), 50.6% were men, and 80.0% were White. Most patients (63.0%) were treated at a community practice, 22.4% at other hospitals, and 14.5% at an academic/NCI-CC. Fewer patients were seeking treatment at community practices over time (72.4% in 2007 to 57.8% in 2015).
Diagnoses of hematologic malignancies were higher at academic/NCI-CC hospitals (51.4%) than at other hospitals (27.4%) or community practices (27.0%). For most patients, cancer therapy was initiated at a community practice (63%).
First treatments were proteasome inhibitor and immunomodulatory drug combinations (PI-IMiDs) for 21% of patients, PI-IMiDs followed by maintenance therapy for 53%, and stem cell transplantation for 4%. Patients were receiving their second (55%), third (31%), or fourth (18%) line of treatment for their MM.
Those with hematologic malignancies were more likely to receive PI-IMiDs during the first line of therapy and to receive a third line of therapy (P <.05).
Compared with academic/NCI-CCs, patients treated at a community practice or other hospital were less likely to receive a fourth line of treatment (adjusted odds ratio [aOR], 0.65; P =.017 and aOR, 0.61; P =.001, respectively) and had poorer overall survival rates (aOR, 1.20; P =.009 and aOR, 1.21; P =.002, respectively).
This study did not include information on adverse events or treatment response.
“In this study we developed and tested a novel claims-based measure of oncologists sub specialization,” stated Amy J. Davidoff, PhD, coauthor of the study.
“We found that hematologic malignancies were associated with increased receipt of first line PI-IMiDs combination therapy and later lines of therapy. The academic/NCI-CC setting was not independently associated with initial treatment but was associated with later lines of therapy and improved overall survival.”
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.
Davidoff AJ, Long JB, Neparidze N, et al. Oncologist sub-specialization, care setting, and multiple myeloma treatment and outcomes. Presented at: American Society of Hematology (ASH) 62nd Annual Meeting and Exposition; December 5-8, 2020. Abstr 308.