Multiple Myeloma In Russia (First Results Of The Registration Trial)

Introduction : Over the past decades, different medicinal products have been used for treatment of multiple myeloma in clinical studies, including new generations of proteasome inhibitors and immunomodulating agents, monoclonal antibodies, histone deacetylase inhibitors etc. The use of these treatment modalities results in improvement of overall survival (OS). However, taking into account high cost of these drugs, their availability in real clinical practice remains limited. Aims: to determine OS in MM patients in real clinical practice in Russia. Materials and methods : 2494 patients aged 24 to 90 years (median age=63 years) with newly diagnosed MM were enrolled into the prospective multicenter registration study from January 1, 2015 till July 1, 2017. The patients received treatment at 43 hematology clinics in Russia. The diagnosis was made based on the IMWG 2014 criteria. Most patients (78%) had stage III of the disease (Durie-Salmon) at the moment of the diagnosis, while stage II and stage I disease was diagnosed in 12% and 10% of cases, respectively. Kidney injury at the time of the disease onset was revealed in 22% of patients; renal replacement therapy (programmed hemodialysis) at the moment of the diagnosis was required in 9% of patients (GFR [Cockcroft-Gault Formula] Results : overall anti-tumor response as a result of the induction therapy was achieved in 64% of patients. Two-year OS was 72%; median period of observation was 17 months. During the study period, 192 fatal outcomes were registered: disease progression - 55%; hemorrhagic complications - 21%; infections - 12%. In the course of the study, the values of OS in MM patients registered in 2015 were compared to the archive data of the registry - 170 patients registered in 2009-2011 who had received treatment at five hematology clinics in Russia. Two-year OS in patients registered in 2015 was statistically significantly higher (p=0.02; log-rank test) compared to patients registered in 2009: 72% versus 60% (Fig. 1). Discussion : The results of this prospective study represent real clinical practice of therapy for MM in Russia. High frequency of newly diagnosed advanced stages of the disease was observed. The first-line therapy regimens in the vast majority of MM patients in Russia include bortezomib, the efficacy of which is comparable to that observed in other regions of the world. The results of the study have demonstrated significant improvement of OS in patients with MM diagnosed in 2015. Disclosures No relevant conflicts of interest to declare.