The relationship of extramedullary disease and high-risk cytogenetics on real-world outcomes among patients with triple-class exposed multiple myeloma

and, separately, whether they were penta-refractory (yes [PENTA+] vs no [PENTA-]).Differences across subgroups were evaluated with respect to patient (pt) characteristics (age, sex, ISS, ECOG, cytogenetics) and treatment history.Progression-free survival (PFS) and overall survival (OS) were compared across these subgroups using Kaplan-Meier methods.Results: N=686 TCE MM pts were included from the COTA database (52.3% had received ≥4 LOT [range 4-14]; 8.6% were PENTA+).Pts with fewer LOT were more likely to have high-risk cytogenetics (26.0%vs 16.7%) but the pt characteristics were otherwise generally similar to pts with ≥4 LOT.There was significant variability in the index treatment regimen, but daratumumab+pomalidomide+ dexamethasone (DPd) (13.5% and 9.7%, respectively) was the most common index regimen for both subgroups.No pt characteristic varied by PENTA status, though DPd was more common among those who were PENTA-(12.0%vs 6.8%).N=787 TCE MM pts were included from the FH database (41.7% had received ≥4 LOT; 4.4% were PENTA+).Pt characteristics did not vary by LOT group; DPd was the most common regimen for both < 4 LOT (7.3%) and ≥4 LOT (9.8%).PENTA+ pts were slightly younger (64.3 vs 67.8 yrs, p