Abstract 3623: Racial disparities in front-line use of novel agents and stem cell transplants among patients with multiple myeloma

Abstract Background: Racial disparities in incidence, mortality, and access to care persist in multiple myeloma (MM). Black/African Americans remain underrepresented in pivotal clinical trials, such as MAIA and PERSEUS, that led to the approval of novel agents like daratumumab (Dara). Dara received FDA approval for frontline use for transplant-ineligible (2018) and transplant-eligible (2019) patients. This study aims to analyze the disparities in the utilization of novel agents and autologous stem cell transplants (ASCT) in MM patients. Methods: We conducted a single-center retrospective study of MM patients diagnosed between January 2022 and December 2023 at Northwell Health, the largest healthcare system in New York. Patients without confirmed MM or complete diagnostic data were excluded. Demographics, MM risk (cytogenetics and Revised International Staging System), time to treatment, time to ASCT, and treatments received were collected and analyzed. Results: A total of 115 patients were included, of which 40 (34.8%) were Black/African American (AA), 46 (40%) White, 9 (7.8%) Asian, and 17 (14.8%) other races; 2.6% had missing race data. The median age at diagnosis was 68.8 years, with no significant difference across racial groups (p=0.21). High-risk cytogenetics, marked by t(4;14), t(14;16), t(14;20), 17p deletion, or 1q amplification, were identified in 22 patients. Stage 2 or 3 disease was observed in 76 patients. At a median follow-up of 13.6 months, 18 patients had died. Only 33.9% of patients received Dara as initial therapy. White patients had the highest proportion of recipients (17/46, 37%), whereas AA patients had the lowest (10/40, 25%). The median time to first treatment was 15 days, with no significant differences by race (p=0.08) or gender (p=0.6). The median time to ASCT was 259 days, with only 23 patients (20%) undergoing ASCT. White patients had the highest transplant rate (30.4%), followed by AA (15%), other races (11.8%), and Asians (11.1%). Non-White patients experienced a longer time to ASCT. Discussions: Despite its demonstrated efficacy and widespread FDA approval, Dara use in frontline treatment remains low, particularly among Black/African Americans, who continue to have disproportionately limited access to novel agents. Similarly, access to ASCT remains inequitable, with lower utilization and longer times to transplant among non-White patients. Barriers such as delayed clinician adoption, drug accessibility, referral patterns, and systemic inequities should be addressed through education, streamlined access pathways, and targeted interventions to ensure equitable care for all MM patients. Citation Format: Phyu Thin Naing, Anthony Corsi, Kelvin Zheng, Divya Chukkalore, Richa Thakur, Juliet Meir, Jessica Caro. Racial disparities in front-line use of novel agents and stem cell transplants among patients with multiple myeloma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3623.