Unite MM: Linking insights for MM patient care
Meeting multiple myeloma (MM) treatment goals is important for health care professionals (HCPs) and patients, but sometimes priorities may differ.1 Understanding differences in priorities as well as awareness of and confidence in the use of recently approved immunotherapies may help improve HCP-patient dialogue during shared treatment-decision making.2
Steering Committee
MM experts, patients, and patient advocacy groups, together with Pfizer, developed a survey designed to understand key barriers to adoption of recently approved immunotherapies and unmet needs in the care of patients with relapsed refractory multiple myeloma (RRMM).
The Steering Committee provided varying perspectives of the MM community (patients, patient advocacy group representatives, and HCPs) based on geography, HCP practice setting, and clinical research focus.
Multidisciplinary Team Membersa
Patients and Patient Advocacy Group Representatives
Yelak Biru
Patient Advocate
International Myeloma Foundation
Solène Clavreul
Patient Advocate
Myeloma Patients Europe
Judith Hume
Patient
Jeff O’Donnell
Patient
Physicians, Nurses, Nurse Practitioners, Pharmacist
Sikander Ailawadhi
Physician
Mayo Clinic
Hannah Belcher
Clinical Nurse Specialist
Cardiff and Value University Health Board
Kevin Brigle
Nurse Practitioner
Massey Comprehensive Cancer Center Virginia Commonwealth University
Nicolas Cormier
Pharmacist
Nantes University Hospital
Yvonne Efebera
Physician
OhioHealth
Max Merz
Physician
University of Leipzig
Albert Oriol
Physician
Catalan Institute of Oncology
Rakesh Popat
Physician
University College London Hospitals NHS Foundation Trust
Maria Teresa
San Miguel
Nurse
University of Navarra Clinic
Kenshi Suzuki
Physician
Japanese Red Cross Medical Center
Elena Zamagni
Physician
Seragnoli Institute of Hematology, University of Bologna
aThe organization names are to show steering committee member affiliations and do not imply endorsement by the respective organizations. Members of the Steering committee have been compensated by Pfizer Inc.
When it comes to adoption of recently approved immunotherapies like bispecific antibodies (BsAbsb), key gaps and unmet needs were uncovered that may impact patient outcomes2
Differences in treatment considerations2
Limited patient awareness of BsAbs2
Low physician confidence in identifying eligible patients2
bIncludes B-cell maturation antigen-directed or G protein–coupled receptor class C group 5 member D-directed BsAbs.3
Survey of Patients with RRMM and HCPs Treating MM2-4
- Objectives2
- Understand HCP and patient priorities during treatment decisions
- Identify gaps in access to MM care
- Identify barriers to adopting recently approved immunotherapies
- Survey format and respondents
- Global, web-based survey of 968 HCPs and 1301 patients with RRMM across 7 countries (US [HCPs: n=251; patients: n=305], UK [HCPs: n=72; patients: n=130], France [HCPs: n=150; patients: n=256], Germany [HCPs: n=65; patients: n=207], Italy [HCPs: n=150; patients: n=162], Spain [HCPs: n=143; patients: n=115], and Japan [HCPs: n=152; patients: n=126]) carried out in 20242,4
- Data analyzed using descriptive statistics, chi-square, and stratified chi-square tests, performed at the global and country level for directional insights3
- cIncludes B-cell maturation antigen-directed or G protein–coupled receptor class C group 5 member D-directed BsAbs. BsAbs do not include HCPs from Japan.3dCAR T-cell therapy does not include HCPs from UK.3
- Patient characteristics3
- 100% had RRMM
- 64% were male and patients’ median age br was 67 years
- 80% had 2 or 3 prior lines of therapy
- 18% had received BsAbsc or chimeric antigen receptor (CAR) T-cell therapyd
- HCP characteristics3
- 61% with 15+ years of experience in RRMM treatment
- Up to 56% of community HCPs and up to 80% of academic HCPs had experience with BsAbsc or CAR T-cell therapiesd
- Academic/COE
- BsAbsc 80%
- CAR T-cell therapyd 61%
- Community/non-COE
- BsAbsc 56%
- CAR T-cell therapyd 25%
- Patient characteristics3
- Data were collected from patients, and grouped based on line of therapy and age, and from HCPs in academic and community settings2
HCPs and patients prioritized different treatment goals during treatment decision-making2
HCPs generally prioritized disease control more than limiting side effects, whereas patients prioritized disease control and limiting side effects equally2
- Differences in Priorities After at Least 2 Relapses2,5
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- Reducing treatment side effects was more important for patients over 65 years old and those with other health conditions (52%; P<0.001)2
- HCPs prioritized limiting side effects 9% more after the 2nd relapse (n=947) compared with after 1st relapse (n=956)2,5
There were differences in how challenging HCPs and patients considered certain side effects3
Top priorities for treatment differed for patients by number of relapses and age2
After the first relapse, patients (n=553) prioritized limiting logistical and caregiver burdens and ensuring treatment without referral more than HCPs (n=956)2,5
- Limiting treatment-related logistical burdenf: 35% of patients vs 17% of HCPs (P<0.001)
- Limiting challenges for caregiversg: 25% of patients vs 13% of HCPs (P<0.001)
- Ensuring treatment without referralh: 24% of patients vs 16% of HCPs (P=0.001)
Younger patients prioritized treatment without referral and treatment administration convenience2
- Ensuring treatment without referralh: 32% of youngeri patients vs 22% of olderj patients (P<0.001)
- Treatment administration conveniencef: 39% of youngeri patients vs 29% of olderj patients (P=0.024)
fIncludes how patients take the treatment or the time required (includes travel, time receiving treatment, and any follow-up visits). gSuch as side effect monitoring, loss of work time, financial burden, and driving time. hWithout referral indicates treatments readily available in their HCP's practice. i<45 years old. j≥45 years old.
After at least 2 relapses, patients (n=748) prioritized reducing financial burdens and preserving future treatment options more than HCPs (n=947)2,5
- Prioritization of Access and Preservation of Future Treatment Options by HCPs and Patients (After 2 or More Relapses)
Key barriers may prevent adoption of recently approved immunotherapies2
- Limited Patient Awareness of BsAbs2,6k
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- Majority of patients (69%, n=808) were unaware of or unfamiliar with BsAbs6
- Most patients who had 2 or more relapses (70%, n=649) were unaware of or unfamiliar with BsAbs2,5
- Only a minority of patients who had 2 or more relapses (14%, n=393) could recall their HCPs suggesting BsAbs as a treatment option2,5
- Yet 71% (n=39/55) of patients who had 2 or more relapses chose BsAbsk when offered2,5l
- Low Confidence Among Some HCPs for Identifying Patients With RRMM Who Are Eligible for BsAbsk
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- 36% of HCPs reported low confidence in identifying patients eligible for BsAbs2
- More community HCPs (42%) reported low confidence compared with academic HCPs (32%)2
- Clinical reasons patients chose BsAbs: Remission, symptom relief, possibility of longer survival2
- Nonclinical reasons patients chose BsAbs: Lower time commitment and financial impact compared with other treatments2
kIncludes B-cell maturation antigen-directed or G protein-coupled receptor class C group 5 member D-directed BsAbs.3 lNot all patients may have been eligible for BsAbs.
Understanding differences in treatment priorities may help inform shared decision-making and optimize patient outcomes through2:
We thank the Steering Committee as well as the HCPs and patients who responded to the surveys and helped us collect these valuable data. Moving forward, we hope to continue to build and strengthen connections within the MM community.
