Policy approach to optimize multiple myeloma treatment sequencing practices

Area of Science:

• Hematology
• Oncology
• Health Economics

Background:

• Multiple myeloma (MM) is now a manageable chronic condition due to therapeutic advances.
• Treatment sequencing in MM has become complex, with novel therapies often reserved for later stages.
• Limited evidence supports the current practice of reserving novel therapies for advanced MM stages.

Purpose of the Study:

• To synthesize insights from multi-stakeholder discussions on MM treatment sequencing.
• To identify drivers of current sequencing practices and explore strategies for evidence-informed optimization.
• To address the complexity of treatment sequencing in an evolving MM therapeutic landscape.

Main Methods:

• A multi-stakeholder discussion involving patients, clinicians, HTA specialists, and industry representatives.
• Synthesis of insights regarding current sequencing practices and their underlying drivers.
• Exploration of potential options for optimizing treatment sequencing.

Main Results:

• Key drivers identified include clinical development constraints, guideline limitations, HTA challenges, financial pressures, and disease burden.
• Options for optimization include new evidence generation, whole-disease modeling, patient involvement, and expanded evaluation frameworks.
• Uncertainty significantly influences MM sequencing decisions, necessitating better evidence.

Conclusions:

• Current MM treatment sequencing practices require re-evaluation to ensure optimal long-term outcomes.
• Addressing uncertainty and improving evidence generation are critical for informed sequencing.
• International collaboration is essential to navigate the complexities of MM treatment sequencing.