Dr. Leleu on the Future of Later-Line Therapy in Multiple Myeloma

Xavier Leleu, MD, PhD, professor, head, Department of Hematology, Centre Hospitalier Universitaire, Université de Poitiers, Poitiers, France, discusses how the declining prognosis of patients with multiple myeloma correlates with line of therapy and time after diagnosis, highlighting an unmet need for more effective later-line therapies in this population.

In a retrospective cohort study on the survival outcomes of patients with multiple myeloma in France, which was presented at the 2022 EHA Congress, 14,309 patients who were diagnosed with multiple myeloma from January 2013 to December 2019 were evaluated using the French National Healthcare Database. This study found that patients with multiple myeloma experienceddeteriorating survival outcomes with increased time from diagnosis and with each additional line of treatment.

Although frontline myeloma treatment is improving, with several new options being introduced over the past decades, therapies in advanced lines are lacking, Leleu says. Once a myeloma drug proves effective and tolerable in later lines, it is moved to the frontline setting, where it can perform even better, Leleu explains. However, no myeloma drugs stay in the advanced setting, and none have been developed specifically for this setting, meaning progress in later lines is often short-lived, Leleu notes.

Patients with multiple myeloma who progress to third or fourth lines of therapy often do so within 5 to 10 years of diagnosis, preventing myeloma from becoming a chronic or curable disease for the majority of patients, Leleu says. This retrospective study emphasizes the need for more effective treatments designed for later-line use, Leleu concludes.