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. 2021 Mar 17;9(1):195–212. doi: 10.1007/s40487-021-00146-4

Table 4.

Description of multiple myeloma treatments

First line
All
(N = 5186)
COPD
(n = 524)
Asthma
(n = 373)
COPD or asthma
(n = 799)
Neither COPD nor asthma (n = 4387)
Type of treatment, n (%)
 IMiDs 3071 (59.22) 288 (54.96) 223 (59.79) 460 (57.57) 2611 (59.52)
  Thalidomide 173 (3.34) 18 (3.44) 16 (4.29) 28 (3.50) 145 (3.31)
  Lenalidomide 2803 (54.05) 258 (49.24) 204 (54.69) 417 (52.19) 2386 (54.39)
  Pomalidomide 126 (2.43) 17 (3.24) 5 (1.34) 21 (2.63) 105 (2.39)
 PIs 2871 (55.36) 305 (58.21) 213 (57.10) 457 (57.20) 2414 (55.03)
  Bortezomib 2684 (51.75) 299 (57.06) 205 (54.96) 445 (55.69) 2239 (51.04)
  Carfilzomib 164 (3.16) 4 (0.76) 10 (2.68) 13 (1.63) 151 (3.44)
  Ixazomib 61 (1.18) 3 (0.57) 2 (0.54) 4 (0.50) 57 (1.30)
 HDAC inhibitors 1 (0.02) 1 (0.19) 0 (0) 1 (0.13) 0 (0)
  Panobinostat 1 (0.02) 1 (0.19) 0 (0) 1 (0.13) 0 (0)
 Monoclonal antibodies 111 (2.14) 9 (1.72) 4 (1.07) 11 (1.38) 100 (2.28)
  Daratumumab 101 (1.95) 9 (1.72) 4 (1.07) 11 (1.38) 90 (2.05)
  Elotuzumab 11 (0.21) 0 (0) 0 (0) 0 (0) 11 (0.25)
  Isatuximab
 Chemotherapy 1188 (22.91) 114 (21.76) 101 (27.08) 184 (23.03) 1004 (22.89)
  Bendamustine 10 (0.19) 1 (0.19) 1 (0.27) 1 (0.13) 9 (0.21)
  Cisplatin 63 (1.21) 6 (1.15) 4 (1.07) 8 (1.00) 55 (1.25)
  Cyclophosphamide 1051 (20.27) 107 (20.42) 90 (24.13) 169 (21.15) 882 (20.10)
  Doxorubicin 126 (2.43) 8 (1.53) 9 (2.41) 16 (2.00) 110 (2.51)
  Etoposide 74 (1.43) 5 (0.95) 5 (1.34) 9 (1.13) 65 (1.48)
  Liposomal doxorubicin 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
  Melphalan 129 (2.49) 7 (1.34) 9 (2.41) 13 (1.63) 116 (2.64)
Top 10 treatment regimens (mono or combination therapy), n (%)
 1 Lenalidomide, 1657 (32.0) Lenalidomide, 160 (30.5) Lenalidomide, 116 (31.1) Lenalidomide, 250 (31.3) Lenalidomide, 1407 (32.1)
 2 Bortezomib, 1041 (20.1) Bortezomib, 136 (26.0) Lenalidomide, bortezomib, 67 (18.0) Bortezomib, 180 (22.5) Bortezomib, 861 (19.6)
 3 Lenalidomide, bortezomib, 831 (16.0) Lenalidomide, bortezomib, 77 (14.7) Bortezomib, 65 (17.4) Lenalidomide, bortezomib, 131 (16.4) Lenalidomide, bortezomib, 700 (16.0)
 4 Bortezomib, cyclophosphamide, 516 (9.9) Bortezomib, cyclophosphamide, 61 (11.6) Bortezomib, cyclophosphamide, 48 (12.9) Bortezomib, cyclophosphamide, 92 (11.5) Bortezomib, cyclophosphamide, 424 (9.7)
 5 Cyclophosphamide, 243 (4.7) Cyclophosphamide, 19 (3.6) Cyclophosphamide, 19 (5.1) Cyclophosphamide, 35 (4.4) Cyclophosphamide, 208 (4.7)
 6 Pomalidomide, 81 (1.6) Pomalidomide, 12 (2.3) Thalidomide, 6 (1.6) Pomalidomide, 15 (1.9) Pomalidomide, 66 (1.5)
 7 Thalidomide, 65 (1.3) Thalidomide, 8 (1.5) Bortezomib, cyclophosphamide, lenalidomide, 6 (1.6) Thalidomide, 11 (1.4) Carfilzomib, 57 (1.3)
 8 Lenalidomide, bortezomib, cyclophosphamide, 65 (1.3) Bortezomib, cyclophosphamide, lenalidomide, 8 (1.5) Lenalidomide, bortezomib, cyclophosphamide, 5 (1.3) Bortezomib, cyclophosphamide, lenalidomide, 11 (1.4) Lenalidomide, bortezomib, cyclophosphamide, 56 (1.3)
 9 Melphalan, 62 (1.2) Lenalidomide, bortezomib, cyclophosphamide, 5 (1.0) Melphalan, 5 (1.3) Lenalidomide, bortezomib, cyclophosphamide, 9 (1.1) Melphalan, 55 (1.3)
 10 Carfilzomib, 60 (1.2) Melphalan, 4 (0.8) Lenalidomide, carfilzomib, 3 (0.8) Melphalan, 7 (0.9) Thalidomide, 54 (1.2)
Stem cell transplant (SCT)
 Yes 319 (6.2) 14 (2.7) 18 (4.8) 30 (3.8) 289 (6.6)
 No 4867 (93.8) 510 (97.3) 355 (95.2) 769 (96.2) 4098 (93.4)
Maintenance therapy, n (%) 186 (3.59) 13 (2.48) 14 (3.75) 24 (3.00) 162 (3.69)
 Bortezomib 23 (0.44) 1 (0.19) 3 (0.80) 4 (0.50) 19 (0.43)
 Lenalidomide 156 (3.01) 12 (2.29) 10 (2.68) 19 (2.38) 137 (3.12)
 Thalidomide 7 (0.13) 0 (0) 1 (0.27) 1 (0.13) 6 (0.14)
Combination therapy, n (%)
 2-agent combination 1614 (31.12) 151 (28.82) 127 (34.05) 245 (30.66) 1369 (31.21)
 3-agent combination 189 (3.64) 20 (3.82) 21 (5.63) 34 (4.26) 155 (3.53)
 4-agent combination 27 (0.52) 2 (0.38) 1 (0.27) 3 (0.38) 24 (0.55)
 ≥ 5-agent combination 63 (1.21) 4 (0.76) 4 (1.07) 7 (0.88) 56 (1.28)
Top 10 therapies by agent, n (%)
 1 Lenalidomide, 2803 (54.05) Bortezomib, 299 (57.06) Bortezomib, 205 (54.96) Bortezomib, 445 (55.69) Lenalidomide, 2386 (54.39)
 2 Bortezomib, 2684 (51.75) Lenalidomide, 258 (49.24) Lenalidomide, 204 (54.69) Lenalidomide, 417 (52.19) Bortezomib, 2239 (51.04)
 3 Cyclophosphamide, 1051 (20.27) Cyclophosphamide, 107 (20.42) Cyclophosphamide, 90 (24.13) Cyclophosphamide, 169 (21.15) Cyclophosphamide, 882 (20.10)
 4 Thalidomide, 173 (3.34) Thalidomide, 18 (3.44) Thalidomide, 16 (4.29) Thalidomide, 28 (3.50) Carfilzomib, 151 (3.44)
 5 Carfilzomib, 164 (3.16) Pomalidomide, 17 (3.24) Carfilzomib, 10 (2.68) Pomalidomide, 21 (2.63) Thalidomide, 145 (3.31)
 6 Melphalan, 129 (2.49) Daratumumab, 9 (1.72) Doxorubicin, 9 (2.41) Doxorubicin, 16 (2.00) Melphalan, 116 (2.64)
 7 Pomalidomide, 126 (2.43) Doxorubicin, 8 (1.53) Melphalan, 9 (2.41) Carfilzomib, 13 (1.63) Doxorubicin, 110 (2.51)
 8 Doxorubicin, 126 (2.43) Melphalan, 7 (1.34) Pomalidomide, 5 (1.34) Melphalan, 13 (1.63) Pomalidomide, 105 (2.39)
 9 Daratumumab, 101 (1.95) Cisplatin, 6 (1.15) Etoposide, 5 (1.34) Daratumumab, 11 (1.38) Daratumumab, 90 (2.05)
 10 Etoposide, 74 (1.43) Etoposide, 5 (0.95) Cisplatin, 4 (1.07) Etoposide, 9 (1.13) Etoposide, 65 (1.48)
Top 5 therapies by type, n (%)
 1 IMiDs, 3102 (59.81) PIs, 306 (58.40) IMiDs, 225 (60.32) IMiDs, 466 (58.32) IMiDs, 2636 (60.09)
 2 PIs, 2909 (56.09) IMiDs, 293 (55.92) PIs, 217 (58.18) PIs, 462 (57.82) PIs, 2447 (55.78)
 3 Chemotherapy, 1453 (28.02) Chemotherapy, 134 (25.57) Chemotherapy, 118 (31.64) Chemotherapy, 216 (27.03) Chemotherapy, 1237 (28.20)
 4 Monoclonal antibodies, 112 (2.16) Monoclonal antibodies, 9 (1.72) Monoclonal antibodies, 4 (1.07) Monoclonal antibodies, 11 (1.38) Monoclonal antibodies, 101 (2.30)
 5 HDAC inhibitors, 1 (0.02) HDAC inhibitors, 1 (0.19) HDAC inhibitors, 1 (0.13)
Characteristics at the end of line of therapy, n (%)
 Treatment augmentation (add-on) 300 (5.78) 25 (4.77) 24 (6.43) 44 (5.51) 256 (5.84)
 Treatment switch 813 (15.68) 60 (11.45) 51 (13.67) 103 (12.89) 710 (16.18)
 Treatment discontinuation 1214 (23.41) 96 (18.32) 84 (22.52) 166 (20.78) 1048 (23.89)
 SCT 59 (1.14) 3 (0.57) 2 (0.54) 5 (0.63) 54 (1.23)
 Death 120 (2.31) 22 (4.20) 15 (4.02) 30 (3.75) 90 (2.05)
 Censored
  Last date of medical activity 720 (13.88) 69 (13.17) 52 (13.94) 105 (13.14) 615 (14.02)
  End of data availability 1960 (37.79) 249 (47.52) 145 (38.87) 346 (43.30) 1614 (36.79)

COPD chronic obstructive pulmonary disease, HDAC histone deacetylase, IMiDs immunomodulatory drugs, PI proteasome inhibitor