Emerging Real-World Treatment Patterns and Clinical Outcomes of Multiple Myeloma in Argentina and Brazil: Insights from the TOTEMM Study in the Private Healthcare Sector

As treatments for multiple myeloma (MM) evolve, there is a need for real-world insights into treatment patterns and outcomes. The <b>t</b>reatment practices and clinical <b>o</b>utcomes in pa<b>t</b>i<b>e</b>nts with <b>MM</b> (TOTEMM) was a database study (2018-2024) of newly diagnosed transplant-ineligible patients with MM in Argentina (TOTEMM-A) and Brazil (TOTEMM-B) in a private healthcare setting. In TOTEMM-A (n = 72) and TOTEMM-B (n = 892), 37 and 92 different drug regimens were reported, respectively. In each country, treatment duration reduced across lines of therapy (LOT) (TOTEMM-A: range, 6.2-3.4 months; TOTEMM-B: range, 4.4-3.5 months); attrition rates increased across LOT (TOTEMM-A: range, 52.8-86.1%; TOTEMM-B: range, 41.9-88.0%); triplet regimens (mainly bortezomib based) were used most frequently in first-line (1L); >75% relapsed within 12 months, regardless of the drug prescribed; over 90% of relapses occurred between 1L and second-line, and up to half of patients were rechallenged with the same drug; >65% of patients experienced disease progression after 1L; and the 1- to 5-year adjusted cumulative risk of progression or death increased across LOT (TOTEMM-A: range, 47.1-88.5%; TOTEMM-B: range, 40.4-91.7%). The rapid and marked progression underscores the urgent need for novel treatments and regimens.