{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:36:32Z","timestamp":1773725792730,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009032","name":"Pfizer UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009032","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Multiple myeloma (MM) prognosis worsens once patients become triple\u2010class exposed (TCE) to at least one treatment in each class: immunomodulators, proteasome inhibitors, and anti\u2010CD38 monoclonal antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study using the Cancer Analysis System database to assess characteristics, treatment patterns, and clinical outcomes for adults diagnosed with MM between 2014 and 2020. The main cohort included patients \u226518 years\u2010old diagnosed with incident MM (including TCE patients) who had at least one record of systemic anticancer therapy treatment within 30 days prior to, on, or any time after their diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The main cohort comprised 14,990 patients, predominantly white and male, with a median age at diagnosis of 71 years. Of these, 848 (5.6%) became TCE. In the main cohort (<jats:italic>n<\/jats:italic>\u00a0=\u00a014,990), 57.2% of patients received only one line of therapy, and &gt;50% of all first\u2010line regimens included bortezomib. Median overall survival (OS) from diagnosis was 51.5 months. After becoming TCE (<jats:italic>n<\/jats:italic>\u00a0=\u00a0848), median OS was 13.2 months and median time to next treatment or death was 5.7 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides current evidence on real\u2010world OS and management for patients with MM in England, including those who become TCE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jha2.70064","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T04:19:12Z","timestamp":1750911552000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics, Treatment Patterns, and Outcomes of Patients with Multiple Myeloma, Including Those Who are Triple\u2010Class Exposed: A Retrospective Cohort Study in England Using National Cancer Registry Data"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8210-5145","authenticated-orcid":false,"given":"Carmen","family":"Tsang","sequence":"first","affiliation":[{"name":"Pfizer Limited, Access and Value  Surrey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0911-5029","authenticated-orcid":false,"given":"Kellyn","family":"Arnold","sequence":"additional","affiliation":[{"name":"IQVIA, Methods and Evidence Generation (MEG)  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Duffield","sequence":"additional","affiliation":[{"name":"Pfizer Limited, Medical Affairs  Surrey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4076-0760","authenticated-orcid":false,"given":"Stavros","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"IQVIA, Methods and Evidence Generation (MEG)  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Price","sequence":"additional","affiliation":[{"name":"Pfizer Limited, Access and Value  Surrey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarana","family":"Mehdikhanova","sequence":"additional","affiliation":[{"name":"IQVIA, Methods and Evidence Generation (MEG)  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7392-7171","authenticated-orcid":false,"given":"Samuel","family":"Wood","sequence":"additional","affiliation":[{"name":"Pfizer Limited, Medical Affairs  Surrey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3560-0132","authenticated-orcid":false,"given":"Mamta","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Haematology University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00135-5"},{"key":"e_1_2_13_3_1","volume-title":"Multiple Myeloma: Definition [Internet]","author":"National Institute for Health and Care Excellence","year":"2022"},{"key":"e_1_2_13_4_1","volume-title":"Myeloma Survival [Internet]","author":"Cancer Research UK","year":"2019"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14213"},{"issue":"4","key":"e_1_2_13_6_1","first-page":"220","article-title":"The Clinical Course of Multiple Myeloma in the Era of Novel Agents: A Retrospective, Single\u2010center, Real\u2010world Study","volume":"1","author":"Szabo A. G.","year":"2019","journal-title":"Clinical Hematology International"},{"key":"e_1_2_13_7_1","volume-title":"NICE Guideline [NG35]: Myeloma: Diagnosis and Management [Internet]","author":"National Institute for Health and Care Excellence","year":"2016"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.11.014"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11122015"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.0003"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-021-00432-4"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17410"},{"key":"e_1_2_13_13_1","volume-title":"Technology Appraisal Guidance [TA970]: Selinexor With Dexamethasone for Treating Relapsed or Refractory Multiple Myeloma After 4 or More Treatments [Internet]","author":"National Institute for Health and Care Excellence","year":"2024"},{"key":"e_1_2_13_14_1","volume-title":"Guidance in Development [GID\u2010TA10918]: Elranatamab for Treating Relapsed and Refractory Multiple Myeloma After 3 or More Treatments [ID4026] [Internet]","author":"National Institute for Health and Care Excellence"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01531-2"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-019-0435-7"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph16111628"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jha2.214"},{"key":"e_1_2_13_19_1","volume-title":"CAS Explorer [Internet]","author":"National Disease Registration Service","year":"2019"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2024.2333439"},{"key":"e_1_2_13_21_1","volume-title":"Cancer Drugs Fund [Internet]","author":"NHS England"},{"key":"e_1_2_13_22_1","volume-title":"Myeloma Statistics [Internet]","author":"Cancer Research UK","year":"2019"},{"key":"e_1_2_13_23_1","volume-title":"Myeloma Incidence Statistics: Myeloma Incidence by Age [Internet]","author":"Cancer Research UK","year":"2021"},{"key":"e_1_2_13_24_1","volume-title":"Myeloma Incidence Statistics: Myeloma Incidence by Gender and UK Country [Internet]","author":"Cancer Research UK","year":"2021"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-022-01718-5"},{"key":"e_1_2_13_26_1","volume-title":"Technology Appraisal Guidance [TA763]: Daratumumab in Combination for Untreated Multiple Myeloma When a Stem Cell Transplant Is Suitable [Internet]","author":"National Institute for Health and Care Excellence","year":"2022"},{"key":"e_1_2_13_27_1","volume-title":"Technology Appraisal Guidance [TA897]: Daratumumab With Bortezomib and Dexamethasone for Previously Treated Multiple Myeloma [Internet]","author":"National Institute for Health and Care Excellence","year":"2023"},{"key":"e_1_2_13_28_1","volume-title":"Technology Appraisal Guidance [TA917]: Daratumumab With Lenalidomide and Dexamethasone for Untreated Multiple Myeloma When a Stem Cell Transplant Is Unsuitable [Internet]","author":"National Institute for Health and Care Excellence","year":"2023"}],"container-title":["eJHaem"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70064","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:50:40Z","timestamp":1756288240000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jha2.70064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/jha2.70064"],"URL":"https:\/\/doi.org\/10.1002\/jha2.70064","archive":["Portico"],"relation":{},"ISSN":["2688-6146","2688-6146"],"issn-type":[{"value":"2688-6146","type":"print"},{"value":"2688-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]},"assertion":[{"value":"2024-11-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70064"}}