Real-World Treatment Patterns and Clinical Outcomes Among Patients With Triple-Class-Exposed and BCMA-Exposed Multiple Myeloma Within the United States.

Introduction: A novel therapy for heavily pretreated triple-class-exposed multiple myeloma (TCE MM) is B-cell maturation antigen (BCMA)-targeted immunotherapy. While the number of TCE+BCMA-exposed patients is growing, real-world data for this group are limited. Methods: We present real-world data from patients with TCE+BCMA-exposed MM who initiated a subsequent line of therapy (LOT) using a US-based claims database, Komodo's Healthcare Map. Results: We identified 656 TCE+BCMA-exposed patients; mean age was 66.5 years. Time from MM diagnosis to index was 5.4 years; mean number of prior LOTs was 5.9. The most prevalent prior therapy received within each drug class was daratumumab (98.5%), pomalidomide (86.0%), carfilzomib (85.8%) and belantamab mafodotin (74.5%). A total of 137 different subsequent treatment regimens were observed following TCE+BCMA exposure; the most common regimen was teclistamab (10.4%). The top three targeted agents within the subsequent regimen were carfilzomib (20.2%), pomalidomide (20.1%) and bortezomib (16.6%). Among this TCE+BCMA-exposed population who received subsequent treatment, the median time to next treatment or death was 6.8 (95% CI, 6.1-7.5) months; time to treatment discontinuation or death was 3.5 (95% CI, 3.2-3.7) months. Conclusion: This first real-world analysis of patients with heavily pretreated TCE+BCMA-exposed MM shows poor clinical outcomes, frequent therapy retreatment and no standard-of-care, highlighting the need for novel treatments. Clinical Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.