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Place in therapy of innovative drugs in multiple myeloma in 2021 and 2023 according to an expert panel Delphi
Boccadoro Mario1, Berto Patrizia2, Bringhen Sara1
1Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino - Italy.
Introduction:
The objective of this study was to understand the potential use of single agents and drug combinations in multiple myeloma (MM) across treatment lines in the years 2021 and 2023.
Methods:
The method used was Delphi Panel Method survey, administered to European Myeloma Network (EMN) Italy Working Group centres. Future treatments were identified assessing all available web-based information sources, including therapies (single drugs or combinations) with strong evidence of efficacy, likely to be on the Italian market in 2021 and 2023. Participants were asked to report on the likelihood of prescription for MM therapies, across treatment lines.
Results:
Across the 15 centres taking part in the survey, about 890 patients per year are forecasted to receive a new diagnosis of MM. In 2021, the Panel forecasted 66% of 1L-TE (transplant eligible) patients will be treated with bortezomib-thalidomide-dexamethasone (VTD) and 32% of patients with daratumumab-bortezomib-thalidomide-dexamethasone (DVTd), with a substantial decrease of VTD (15%) and a marked increase of DVTd (81%) forecasted for 2023. The 2L and 3L R(lenalidomide)-based combination treatments are expected to drop and will likely be substituted by a steep increase in P(pomalidomide)-based regimes (from 7% to 23%). On the contrary, in 3L treatment, all combination therapies (with the exception of IsaPd - isatuximab-pomalidomide-dexamethasone) are expected to lose market share in favour of the most recent new therapies.
Conclusions:
Expert Panel agrees that many different new drugs and combinations will be used in MM, with different mechanisms of action, both at diagnosis and in subsequent phases of the disease, with a corresponding decline of the drugs currently used.
Insights
Future multiple myeloma treatments will see a shift towards new drug combinations, with a decline in current therapies. Experts predict significant changes in treatment lines by 2023, emphasizing novel therapeutic approaches.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Multiple myeloma (MM) treatment landscape is evolving with new therapeutic agents.
- Understanding future treatment patterns is crucial for clinical practice and drug development.
Purpose of the Study:
- To forecast the utilization of single agents and drug combinations in multiple myeloma (MM) across different treatment lines for 2021 and 2023.
- To identify emerging trends in MM therapy based on expert opinion and available evidence.
Main Methods:
- A Delphi Panel Method survey was administered to the European Myeloma Network (EMN) Italy Working Group.
- Future treatments were identified by assessing web-based information sources for therapies likely to be available in Italy by 2021 and 2023.
- Participants reported the likelihood of prescription for MM therapies across various treatment lines.
Main Results:
- In 2021, bortezomib-thalidomide-dexamethasone (VTD) was forecasted for 66% of transplant-eligible patients, with daratumumab-bortezomib-thalidomide-dexamethasone (DVTd) at 32%.
- By 2023, VTD is projected to decrease to 15%, while DVTd is expected to rise significantly to 81%.
- Lenalidomide-based regimens in 2nd and 3rd lines are predicted to decline, with an increase in pomalidomide-based regimens (from 7% to 23%).
Conclusions:
- The expert panel anticipates a broad adoption of novel drugs and combinations in multiple myeloma, impacting both initial diagnosis and subsequent treatment phases.
- A decline in the use of currently established therapies is expected as new treatments with diverse mechanisms of action become available.
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