(PA-483) Understanding Different Treatment (Tx) Goals and Experiences According to Characteristics in Relapsed/refractory Multiple Myeloma (RRMM)

Tx choices in RRMM pose challenges due to patient (pt) and disease heterogeneity. Personalizing the approach to decision-making and Tx choice based on understanding these differences may help improve the overall pt experience and relationships with health care professionals (HCPs).

Methods:

To better understand the unmet need within pt groups, 30-min online surveys were conducted across 7 countries (March-June 2024). Data were analyzed using descriptive statistics and χ² tests (P<.01 for comparisons, unless specified).  

Results:

Pts with RRMM (n=1301) and oncologists (n=983) participated. Multivariate analysis identified that financial burden, age, and comorbidities are significantly associated with a Tx meeting pt expectations.

Pts with high financial burden prioritized slowing down disease (57% v 42%), limiting side effects (AEs; 57% v 34%), and limiting costs (40% v 26%). Their Tx experience was reported to be significantly worse than expected v more financially stable pts.

The greatest priorities for pts aged ≥65 y was limiting AEs (53% v 33% for pts <65 y) and slowing disease progression (53% v 40%). They faced worse physical burdens (78% v 69%, P=.024) and their Tx experience was worse than expected for quality of life (QOL; 53% v 20%), AEs (59% v 19%), and mental health (56% v 21%). Emotional/mental burden was not significantly different.

Pts with ≥3 comorbidities faced more physical and emotional burdens and experienced worse than expected Tx outcomes than pts with <3 comorbidities (36%-60% v 33%-43%), notably QOL (60% v 38%). Pts with ≥3 comorbidities ranked limiting costs (39%), limiting AEs (53%), and slowing disease worsening (55%) over living longer (30%).

Fewer females v males were in remission (27% v 42%). Not being in remission was strongly associated with females feeling greater physical burden (78% v 73%, P=.035) and with Tx outcomes being worse than expected for females, including for perceived efficacy (42% v 32%), impact on mental health (52% v 39%) and QOL (50% v 37%), and females facing more financial difficulties (39% v 28%) and comorbidities (76% v 67%). Fewer females were treated by specialists (49% v 59%; weakly associated with remission). Emotional/mental burden was similar (64% v 60%).

Pts in 2L Tx considered convenience to be more important than those in ≥3L (35% v 26%). Pts in ≥3L perceived their Tx and care to have a worse impact on mental health than expected (49% v 2L, 36%).

Only 13% of pts preferred HCPs to make Tx decisions alone (more so in pts <65 v ≥65 y [21% v 8%] and in 2L v ≥3L [17% v 10%]). However, HCPs reported recommending Tx without discussing pt goals in 22% of cases. Pts wanted more discussion on AEs and safety risks (42%), impact on mental health (42%), and possible impact of AEs on daily life (41%). HCPs reported discussing more topics than pts recalle

Conclusions:

Pt characteristics are associated with differing burdens, Tx goals, and experiences. Understanding this is vital to tailoring Tx choices to meet pt expectations.