@article{3085843,
    title = "Multiple Myeloma Treatment in Real-world Clinical Practice: Results of a Prospective, Multinational, Noninterventional Study",
    author = "Mohty, M. and Terpos, E. and Mateos, M.-V. and Cavo, M. and Lejniece, S. and Beksac, M. and Bekadja, M.A. and Legiec, W. and Dimopoulos, M. and Stankovic, S. and Durán, M.S. and De Stefano, V. and Corso, A. and Kochkareva, Y. and Laane, E. and Berthou, C. and Salwender, H. and Masliak, Z. and Pečeliūnas, V. and Willenbacher, W. and Silva, J. and Louw, V. and Nemet, D. and Borbényi, Z. and Abadi, U. and Pedersen, R.S. and Černelč, P. and Potamianou, A. and Couturier, C. and Feys, C. and Thoret-Bauchet, F. and Boccadoro, M. and Bekadja, M. and Hamladji, R.-M. and Ali, H.A. and Hamdi, S. and Touhami, H. and Mansour, N.S. and Linkesch, W. and Abildgaard, N. and Hein, M. and Eveillard, J.R. and Yamani, A.E. and Moreau, P. and Sanhes, L. and Lepeu, G. and Laribi, K. and Jourdan, E. and Fitoussi, O. and Allangba, O. and Fleury, J. and Escoffre, M. and Benramdane, R. and Cartron, G. and Dine, G. and Legouffe, E. and Harich, H.-D. and Illmer, T. and Dörfel, S. and Hannig, C.V. and Koenigsmann, M. and Prange-Krex, G. and Tamm, I. and Zeller, W. and Maasberg, M. and Schlag, R. and Klausmann, M. and Uhlig, J. and Alkemper, B. and Schütz, S. and Tessen, H.-W. and Mohr, B. and Schmidt, P. and Heinrich, B. and Hebart, H. and Seipelt, G. and Zoeller, T. and Heits, F. and Müller-Naendrup, C. and Hansen, R. and Repp, R. and Von Weikersthal, L.F. and Schmits, R. and Heßling, J. and Krammer-Steiner, B. and Janzen, V. and Schauer, M. and Grüner, M.W. and Kisro, J. and Denzlinger, C. and Freier, W. and Junghanss, C. and Görner, M. and Laichinger, K. and Ostermann, H. and Dürk, H. and Hess, G. and Reich, G. and Matsouka, P. and Pouli, A. and Anagnostopoulos, A. and Masszi, T. and Ivanyi, J. and Szomor, A. and Nagler, A. and Magen, H. and Avivi, I. and Quitt, M. and Palumbo, A. and Za, T. and Vallisa, D. and Foa, R. and Bosi, A. and Vacca, A. and Lanza, F. and Palazzo, G. and Avvisati, G. and Ferrara, F. and Consoli, U. and Cantonetti, M. and Angelucci, E. and Califano, C. and Di Raimondo, F. and Guarini, A. and Musso, M. and Pizzuti, M. and Giuliani, N. and Ardizzoia, A. and Di Renzo, N. and Gaidano, G. and Gozzetti, A. and Pitini, V. and Farina, G. and Centurioni, R. and De Fabritiis, P. and Iuliano, F. and La Nasa, G. and La Verde, G. and Pane, F. and Recine, U. and La Targia, M. and Mineo, G. and Cangialosi, C. and Fagnani, D. and Federici, A. and Romano, A. and Specchia, G. and Storti, S. and Bongarzoni, V. and Bacigalupo, A. and Gobbi, M. and Latte, G. and Mannina, D. and Capalbo, S. and Jurgutis, M. and Woszczyk, D. and Hołojda, J. and Gornik, S. and Pluta, A. and Morawiec-Szymonik, E. and Kyrcz-Krzemien, S. and Homenda, W. and Grosicki, S. and Sulek, K. and Lange, A. and Kloczko, J. and Starzak-Gwozdz, J. and Hellmann, A. and Komarnicki, M. and Kuliczkowski, K. and Viveiros, C. and Gonçalves, C. and Esefyeva, N. and Kaplanov, K. and Volodicheva, E. and Laricheva, E. and Dergacheva, V. and Chukavina, M. and Volchenko, N. and Nazarova, I. and Anchukova, L. and Ovanesova, E. and Salogub, G. and Magomedova, L. and Kuznetsova, I. and Osyunikhina, S. and Serdyuk, O. and Karyagina, E. and Ivanova, V. and Černelč, S.P. and Coetzee, C. and Gunther, K. and Moodley, D. and Duran, S. and Gutiérrez, A.E. and De Oteyza, J.P. and Capote, F.J. and Casanova, M. and Sanchez, J.M. and Rios-Herranz, E. and Ibañez-Garcia, J. and Herranz, M.J. and Hernandez, B. and Sanchez, S.S. and Escalante, F. and Carnicero, F. and Lleonart, J.B. and Gironella, M. and Martínez, R. and De La Guia, A.L. and Palomera, L. and Iglesias, R. and Ramos, F.S. and De La Serna, J. and Sanchez, P.G. and Vidal, J.B. and Morfa, M.D. and Beksac, T.-M. and Vural, F. and Aydin, Y. and Unal, A. and Goker, H. and Bilgir, O. and Guvenc, B. and Turgut, M. and Ozet, G.G. and Ali, R. and Kyselyova, M. and Glushko, N. and Vybyrana, R. and Skrypnyk, I. and Tretyak, N. and Kharchevska, T. and Dyagil, I. and Popovs'ka, T. and Shimanskiy, V. and Lysa, T. and Oliynyk, H. and Vilchevskaya, K. and Kryachok, I. and Popovych, Y. and Romanyuk, N. and Yushchenko, N. and Kaplan, P. and Rekhtman, G. and Pylypenko, H. and Kozlov, V. and Drach, J. and Harousseau, J.-L. and Einsele, H. and Goldschmidt, H. and Facon, T. and Michalet, M. and Savchenko, V.G. and De la Rubia, J. and Cook, G. and Mellqvist, U.-H. and Ludwig, H. and EMMOS Investigators",
    journal = "Clinical Lymphoma Myeloma and Leukemia",
    year = "2018",
    volume = "18",
    number = "10",
    pages = "e401-e419",
    publisher = "W B SAUNDERS CO-ELSEVIER INC",
    doi = "10.1016/j.clml.2018.06.018",
    keywords = "bortezomib;  lenalidomide;  thalidomide;  antineoplastic agent;  boronic acid derivative;  bortezomib;  dexamethasone;  lenalidomide;  thalidomide, adult;  adverse drug reaction;  Article;  cancer combination chemotherapy;  cancer epidemiology;  cancer screening;  cancer staging;  clinical practice;  drug efficacy;  drug safety;  female;  health economics;  human;  major clinical study;  male;  multicenter study;  multiple myeloma;  observational study;  peripheral neuropathy;  pharmacoepidemiology;  prospective study;  salvage therapy;  sensory neuropathy;  treatment response;  aged;  clinical practice;  clinical trial;  follow up;  middle aged;  multiple myeloma;  pathology;  salvage therapy;  survival rate;  treatment outcome;  tumor recurrence;  very elderly, Adult;  Aged;  Aged, 80 and over;  Antineoplastic Combined Chemotherapy Protocols;  Boronic Acids;  Bortezomib;  Dexamethasone;  Female;  Follow-Up Studies;  Humans;  Lenalidomide;  Male;  Middle Aged;  Multiple Myeloma;  Neoplasm Recurrence, Local;  Practice Patterns, Physicians';  Prospective Studies;  Salvage Therapy;  Survival Rate;  Thalidomide;  Treatment Outcome",
    abstract = "Multiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits. © 2018 The Authors"
}