Summary
Black patients with multiple myeloma (MM) in the US have a greater incidence rate, inferior survival, and younger onset of MM vs other races. This analysis evaluated differences in clinical characteristics between Black patients compared with other races with MM to determine the impact on survival outcomes.
Methods
Data were retrospectively collected from the ConcertAI Patient360 database containing aggregated electronic health record data of patients treated in US-based oncology centers. Adult patients diagnosed with MM (2011–2022) who received ≥1 line of systemic therapy and had ≥3-month follow up were included. Patients were stratified by race (Black vs other [American Indian/Alaska Native, Asian, Native Hawaiian/other Pacific Islander, White, and other/unknown]). Baseline characteristics were compared between races using Chi-squared tests. Outcomes included first-line (1L), overall survival (OS), and progression-free survival (PFS), estimated by Kaplan-Meier. The impact of race and characteristics on outcomes was evaluated with Cox proportional hazards models.
Results
Black patients (n=806) vs other races (n=3164), were younger (63.3 vs 67.4 years, p<0.001) with greater prevalence of concurrent cancer (13.3% vs 10.6%, p=0.027) at time of diagnosis, and higher baseline mean Charlson Comorbidity Index (CCI) score (0.48 vs 0.39, p=0.047). Black patients vs other races more frequently had diabetes without complications (14.8% vs 10.3%, p<0.001), renal disease (3.7% vs 1.7%, p<0.001), and AIDS/HIV (1.4% vs 0.1%, p<0.001), and 1L therapy regimen use (p=0.56) did not differ between races. The proportion progressing to 3L was 20.5% vs 19.2% among Black vs other races. Among overall patients, median (95% CI) 1L OS and PFS in months was similar between Black patients and other races (OS: 129 [109, 167] vs 133 [122, 157]; PFS: 39.5 [35.0, 45.3] vs 38.1 [36.2, 40.5]). Survival outcomes did not differ between races before (Hazard ratio [HR] [95% CI]; OS: 0.97 [0.84, 1.11]; PFS: 0.91 [0.82, 1.01]) or after adjusting for patient characteristics (OS: 1.13 [0.97, 1.31]; PFS: 1.0 [0.89, 1.12]). Characteristics impacting outcomes regardless of race included age (50–64 vs <50 years; OS: 1.48 [1.13, 1.95]); PFS: 1.32 (1.11, 1.57), CCI score (OS: 1.15 [1.10, 1.20]; PFS: 1.06 [1.02, 1.10]), and ECOG score 2–4 vs 0–1 (OS: 1.76 [1.08, 1.37]; PFS: 1.52 [1.35, 1.71]; p<0.01).
Conclusions
Although 1L survival outcomes were similar between races, Black patients were younger at diagnosis with more comorbidities. Since improved survival outcomes were associated with younger age, fewer comorbidities and lower ECOG score, prompt diagnosis and care are needed.
