The Impact of Treatment Time Toxicity on Regimen Selection in Multiple Myeloma: A Single-Center Retrospective Study

Objective In cancer care, the patient burden encompasses not only physical and psychological toxicity, but also financial and time toxicity. Multiple myeloma (MM) requires ongoing therapy. However, the impact of time toxicity on treatment decision-making is unclear. Methods We retrospectively reviewed the medical records of the patients diagnosed with MM between April 1, 2010, and March 31, 2023, at a single center. The collected data included M-protein type, age at diagnosis, sex, Eastern Cooperative Oncology Group performance status (ECOG PS), employment status, commute time, and receipt of ixazomib, lenalidomide, and dexamethasone (IRd) therapy. Results Of the 97 identified patients, 74 with relapsed/refractory MM were included in the main analysis. The mean commute time was 74.5 min for patients who received IRd therapy and 46.3 min for those who did not. When the patients were stratified by commute time (≥65 min, Long group), 52.9% of the long group received IRd compared with 19.3% in the not-long group. In multivariable logistic regression, the longer commute time was significantly associated with IRd use (odds ratio, 4.63; 95% CI, 1.45-15.4; p = 0.009). Conclusion Our findings suggest that longer commute times may be associated with treatment selection, thus highlighting the time burden as an important factor in real-world decision-making for MM.