{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T14:41:09Z","timestamp":1774276869775,"version":"3.50.1"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010793","name":"Pfizer Japan Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010793","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Treatment trends for newly diagnosed multiple myeloma (NDMM) are not fully evaluated in real-world settings in the Japanese population. Triple-class exposed (TCE) patients with relapsed or refractory MM have a poor prognosis and limited treatment options. To clarify characteristics, treatment trends, and TCE status in Japanese patients with MM, we conducted a retrospective, non-interventional study. Data from patients with MM were extracted from a Japanese claims database between 2015 and 2022: this study identified patients with NDMM prescribed daratumumab (D), lenalidomide (R), and\/or bortezomib (V) as 1st-line treatment. The patient characteristics and treatment trends were analyzed for non-transplant and transplant groups. Of 1,784 patients, non-transplant patients (n = 1,656, median age 75 years [range: 37\u201394]) received R+dexamethasone (Rd) (24.7%), Vd (23.8%), and RVd (15.6%) and transplant patients (n = 128, median age 61 years [range: 35\u201373]) received RVd (49.5%), Vd (18.7%), and DVd (8.4%) in 1<jats:sup>st<\/jats:sup> line. In the non-transplant group, the commonly prescribed treatment regimens were Rd for patients aged \u226575 years, Vd for patients aged 65\u201374 years, and RVd for patients aged &lt;65 years. Patients with renal or cardiac dysfunction commonly received Vd or Rd, respectively. In the transplant group, 107 (83.6%) and 20 (15.6%) patients received transplantation in the 1st and 2nd lines, respectively. The top three regimens as induction therapy before stem cell transplantation were RVd (49.5%), Vd (18.7%), or DVd (8.4%) in 1st line. Cumulative TCE patients by 5th line were 351 (21.2%) and 56 (43.8%) for non-transplant and transplant patients, respectively. TCE ratio at each line gradually increased from 1st to 5th line (11.1\u201369.2% in the non-transplant group and 21.1\u2013100% in the transplant group, respectively). Of 184 TCE patients in the non-transplant group, 89.7% received sequencing treatments including DRd, RVd, and DVd, and 10.3% received D-RVd in 1<jats:sup>st<\/jats:sup> line.<\/jats:p>","DOI":"10.1371\/journal.pone.0310333","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T17:35:57Z","timestamp":1727717757000},"page":"e0310333","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real-world treatment trends and triple class exposed status in newly diagnosed multiple myeloma patients in Japan: A retrospective claims database study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7035-8791","authenticated-orcid":true,"given":"Toyoki","family":"Moribe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linghua","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazumi","family":"Take","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohiro","family":"Yonemoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenshi","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"pone.0310333.ref001","article-title":"International Agency for Research on Cancer, World Health Organization, in Cancer Fact Sheet","author":"Global Cancer Observatory","year":"2020"},{"key":"pone.0310333.ref002","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s12185-019-02636-8","article-title":"JSH practical guidelines for hematological malignancies. 2018: III. Myeloma-1. Multiple myeloma (MM).","volume":"109","author":"S Iida","year":"2019","journal-title":"Int J Hematol"},{"key":"pone.0310333.ref003","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1016\/S1470-2045(16)30206-6","article-title":"International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma","volume":"17","author":"S Kumar","year":"2016","journal-title":"Lancet Oncol"},{"key":"pone.0310333.ref004","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1080\/13696998.2019.1686870","article-title":"Current treatment patterns and medical costs for multiple myeloma in Japan: a cross-sectional analysis of a health insurance claims database.","volume":"23","author":"S Uno","year":"2020","journal-title":"J Med Econ"},{"key":"pone.0310333.ref005","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3820\/jjpe.25.e2","article-title":"Treatment patterns in newly diagnosed multiple myeloma patients in Japan using a large-scale claims database: retrospective cohort study.","volume":"25","author":"J Guan","year":"2020","journal-title":"Japan J Pharmacoepidemiol\/Yakuzai Ekigaku."},{"issue":"Supplement 1","key":"pone.0310333.ref006","doi-asserted-by":"crossref","first-page":"5156","DOI":"10.1182\/blood-2022-157676","article-title":"Real-world treatment patterns and outcomes of patients with newly diagnosed multiple myeloma: an analysis using national health insurance service database","volume":"140","author":"Y Lee","year":"2022","journal-title":"Blood"},{"key":"pone.0310333.ref007","doi-asserted-by":"crossref","first-page":"e0283931","DOI":"10.1371\/journal.pone.0283931","article-title":"Treatment pattern and clinical outcomes in multiple myeloma patients in Japan using the Medical Data Vision claims database.","volume":"18","author":"H Handa","year":"2023","journal-title":"PLoS One"},{"key":"pone.0310333.ref008","doi-asserted-by":"crossref","first-page":"e0285947","DOI":"10.1371\/journal.pone.0285947","article-title":"Survival outcomes among patients with multiple myeloma in the era of novel agents: exploratory assessment using an electronic medical record database in Japan.","volume":"18","author":"S Uno","year":"2023","journal-title":"PLoS One"},{"key":"pone.0310333.ref009","doi-asserted-by":"crossref","first-page":"3839","DOI":"10.2217\/fon-2022-0846","article-title":"Practice patterns and outcomes for triple-class exposed patients with relapsed\/refractory multiple myeloma in Japan.","volume":"18","author":"S Iida","year":"2022","journal-title":"Future Oncol"},{"key":"pone.0310333.ref010","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3390\/jcm10010105","article-title":"Real-world data on clinical features, outcomes, and prognostic factors in multiple myeloma from Miyazaki prefecture, Japan.","volume":"10","author":"K Akizuki","year":"2020","journal-title":"J Clin Med"},{"key":"pone.0310333.ref011","unstructured":"MDV database 2023, Medical Data Vision Database. Available at https:\/\/en.mdv.co.jp\/ebm\/about-mdv-database\/mdv-database-overview\/ Accessed on November 20, 2023."},{"key":"pone.0310333.ref012","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s40801-022-00296-5","article-title":"Context and considerations for use of two Japanese real-world databases in Japan: Medical Data Vision and Japanese Medical Data Center.","volume":"9","author":"T Laurent","year":"2022","journal-title":"Drugs Real World Outcomes."},{"key":"pone.0310333.ref013","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1056\/NEJMoa1505654","article-title":"Elotuzumab therapy for relapsed or refractory multiple myeloma","volume":"373","author":"S Lonial","year":"2015","journal-title":"New Engl J Med"},{"key":"pone.0310333.ref014","doi-asserted-by":"crossref","first-page":"53","DOI":"10.2147\/BLCTT.S82444","article-title":"Use of carfilzomib in second-line therapy and beyond for relapsed multiple myeloma","volume":"7","author":"D Bhutani","year":"2017","journal-title":"Blood Lymphat Cancer"},{"key":"pone.0310333.ref015","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1056\/NEJMoa1611750","article-title":"Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma","volume":"376","author":"M Attal","year":"2017","journal-title":"New Engl J Med"},{"key":"pone.0310333.ref016","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1002\/ajh.24335","article-title":"Bortezomib-based triplets are associated with a high probability of dialysis independence and rapid renal recovery in newly diagnosed myeloma patients with severe renal failure or those requiring dialysis","volume":"91","author":"MA Dimopoulos","year":"2016","journal-title":"Am J Hematol"},{"key":"pone.0310333.ref017","doi-asserted-by":"crossref","first-page":"e293","DOI":"10.1016\/S1470-2045(23)00223-1","article-title":"Management of multiple myeloma-related renal impairment: recommendations from the International Myeloma Working Group","volume":"24","author":"MA Dimopoulos","year":"2023","journal-title":"Lancet Oncol"},{"key":"pone.0310333.ref018","doi-asserted-by":"crossref","first-page":"612696","DOI":"10.3389\/fmed.2021.612696","article-title":"Approaches and challenges in the management of multiple myeloma in the very old: future treatment prospects.","volume":"8","author":"NM Kaweme","year":"2021","journal-title":"Front Med."},{"key":"pone.0310333.ref019","doi-asserted-by":"crossref","first-page":"e480","DOI":"10.3324\/haematol.2019.236588","article-title":"Early relapse after autologous transplant for myeloma is associated with poor survival regardless of cytogenetic risk","volume":"105","author":"J Corre","year":"2020","journal-title":"Haematologica"},{"key":"pone.0310333.ref020","doi-asserted-by":"crossref","DOI":"10.7812\/TPP\/19.012","article-title":"Predictive factors for early relapse in multiple myeloma after autologous hematopoietic stem cell transplant","volume":"23","author":"AM Pourmoussa","year":"2019","journal-title":"Perm J"},{"key":"pone.0310333.ref021","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1038\/s41408-020-00359-2","article-title":"Multiple myeloma current treatment algorithms","volume":"10","author":"SV Rajkumar","year":"2020","journal-title":"Blood Cancer J"},{"key":"pone.0310333.ref022","doi-asserted-by":"crossref","first-page":"e349","DOI":"10.1038\/bcj.2015.79","article-title":"Trends of survival in patients with multiple myeloma in Japan: a multicenter retrospective collaborative study of the Japanese Society of Myeloma","volume":"5","author":"S Ozaki","year":"2015","journal-title":"Blood Cancer J"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310333","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T17:36:09Z","timestamp":1727717769000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310333"}},"subtitle":[],"editor":[{"given":"Mehmet","family":"Baysal","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,9,30]]},"references-count":22,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0310333","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,30]]}}}