Perspectives of Healthcare Providers and Patients with Relapsed/Refractory Multiple Myeloma on Treatment Priorities and Novel Therapies

Sikander Ailawadhi,1 Yelak Biru,2 Solène Clavreul,3 Maite San Miguel,4 Nicolas Cormier,5 Yvonne Efebera,6 Maximilian Merz,7 Anna Sato,8 Cathy Zeanah,9 Jack L Watkins,10 James Farrell,11 Erinn Hoag Goldman,10 Rakesh Popat12 1Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA; 2International Myeloma Foundation, Studio City, CA, USA; 3Myeloma Patients Europe, Brussels, Belgium; 4Cancer Center Clínica Universidad de Navarra, Pamplona, Spain; 5Centre Hospitalier Universitaire de Nantes, Nantes, France; 6OhioHealth, Columbus, OH, USA; 7Multiple Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Hematology and Cell Therapy, University of Leipzig, Leipzig, Germany; 8ZS Associates, New York, NY, USA; 9ZS Associates, Philadelphia, PA, USA; 10Pfizer Inc, New York, NY, USA; 11Pfizer Ltd, Dublin, Ireland; 12National Institute for Health Research Clinical Research Facility, University College London Hospitals NHS Trust, London, UKCorrespondence: Sikander Ailawadhi, Division of Hematology and Medical Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA, Tel +1 904-953-2000, Email [email protected]: With novel therapies including chimeric antigen receptor T-cell (CAR-T) therapy and bispecific antibodies (BsAbs), healthcare providers (HCPs) face complexities managing treatment for patients with relapsed/refractory multiple myeloma (RRMM). This study, among the largest surveys on RRMM, examined unmet needs in care access, barriers to novel therapy use, and treatment decision-making.Methods: This survey-based study (March-June 2024) enrolled 2284 participants (patients: 1301; HCPs: 983) across 7 countries. Patients with > 1 relapse/progression and HCPs managing ≥ 3 patients were included. Data were analyzed using descriptive statistics and &KHgr;2 tests.Results: For patients, treatment priorities included slowing disease progression (second line [2L], 47%; third or later line [≥ 3L], 49%), minimizing adverse events (AEs; 2L, 43%; ≥ 3L, 49%), and extending life (2L, 39%; ≥ 3L, 38%). HCPs prioritized prolonging survival and controlling disease. Younger patients (< 65 vs ≥ 65 years) prioritized convenience (40% vs 24%; P< 0.01) and avoiding referrals to new institutions for therapies (32% vs 20%; P< 0.01). Across geographies, HCPs reported logistical challenges as key reasons that CAR-T (38%) or BsAb (34%) therapy was not offered. Novel therapies were offered to patients more frequently in the US vs EU (CAR-T, 84% vs 77%, P=0.023; BsAbs, 84% vs 76%, P=0.011), with a similar trend in the US vs Japan for CAR-T; however, across all geographies, few patients recalled being offered CAR-T (17%) or BsAbs (13%). Patients receiving BsAbs prioritized efficacy-related reasons (25– 35%) and nonclinical factors like less time and financial impact (27– 29%), whereas those who received CAR-T prioritized patient success stories (50%), efficacy-related factors (48– 50%), and minimal financial burden (43%).Conclusion: This study revealed gaps in treatment priorities; patients valued quality of life and AE management, while HCPs focused on efficacy and delaying progression. There is a significant need to educate HCPs and patients on the impact of shared decision-making when considering novel treatments for RRMM.Keywords: bispecific antibodies, CAR-T therapy, patient perspectives, surveys