{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:11:46Z","timestamp":1781525506126,"version":"3.54.1"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015542","name":"GlaxoSmithKline Japan","doi-asserted-by":"publisher","award":["217837"],"award-info":[{"award-number":["217837"]}],"id":[{"id":"10.13039\/100015542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Approval of proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies (mAbs), such as daratumumab, has reshaped treatment patterns in patients with multiple myeloma (MM) in Japan. This retrospective study evaluated patient characteristics, treatment patterns, and trends in MM patients using Medical Data Vision, the largest electronic health records database in Japan with anonymous inpatient and outpatient health information.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients aged \u226518 years, with \u22652 records of an MM diagnostic and disease code and \u22651 record of MM treatment between 01 April 2008 and 30 June 2023 were included. Patients starting first-line (1L) treatment on or after 01 January 2020 were categorized into the 1+L cohort; those starting second-line (2L) treatment on or after 01 January 2018 were allocated to the 2+L cohort.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Within the study period, 21,066 patients had an MM diagnosis, including 6,337 and 5,964 patients in the 1+L and 2+L cohorts, respectively. Median age was 74 years in both cohorts and gender distribution was similar (52.4% and 51.3% males, respectively). In the 1+L cohort, most patients (5,754\/6,337; 90.8%) did not receive transplant, among whom 51.0% received 1L lenalidomide-based therapy, primarily daratumumab\/lenalidomide\/dexamethasone (DRd; 15.0%) or lenalidomide\/dexamethasone (Rd;14.0%). In non-transplant patients, 1L DRd use increased from 6.0% in January\u2013June 2020 to 28.0% in January\u2013June 2023. In the 2+L cohort, 2L lenalidomide-based therapy use decreased from 65.0% in January\u2013June 2018 to 37.0% in January\u2013June 2023; daratumumab-based therapy increased from 14.0% to 39.0%. Retreatment with lenalidomide-, daratumumab-, and isatuximab-based therapy occurred in 44.1%, 35.2%, and 5.6% of patients, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The high use of lenalidomide and DRd in 1L, and high rates of retreatment with lenalidomide and anti-CD38 mAbs in 2L+ indicate a substantial need for new treatment modalities that can be used in 2L+ patients who previously received lenalidomide with\/without an anti-CD38 mAb therapy.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0315932","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T18:29:24Z","timestamp":1737656964000},"page":"e0315932","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Characteristics and treatment patterns in patients with multiple myeloma in Japan: A retrospective cohort analysis"],"prefix":"10.1371","volume":"20","author":[{"given":"Shinsuke","family":"Iida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1853-974X","authenticated-orcid":true,"given":"Yusuke","family":"Yasutomi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3561-5585","authenticated-orcid":true,"given":"Yevgeniy","family":"Samyshkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Chang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen Shi","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9909-5649","authenticated-orcid":true,"given":"Seok-Won","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"McGuiness","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8069-7860","authenticated-orcid":true,"given":"Zifan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"McNamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"issue":"5","key":"pone.0315932.ref001","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"},{"issue":"suppl_4","key":"pone.0315932.ref002","doi-asserted-by":"crossref","first-page":"iv52","DOI":"10.1093\/annonc\/mdx096","article-title":"Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"28","author":"P Moreau","year":"2017","journal-title":"Ann Oncol"},{"key":"pone.0315932.ref003","article-title":"Practice patterns and outcomes for triple-class exposed patients with relapsed\/refractory multiple myeloma in Japan","author":"S Iida","year":"2022","journal-title":"Future Oncol"},{"issue":"6","key":"pone.0315932.ref004","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/s41408-022-00695-5","article-title":"Gaps and opportunities in the treatment of relapsed-refractory multiple myeloma: Consensus recommendations of the NCI Multiple Myeloma Steering Committee","volume":"12","author":"S Kumar","year":"2022","journal-title":"Blood Cancer J"},{"issue":"5","key":"pone.0315932.ref005","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s12185-019-02636-8","article-title":"JSH practical guidelines for hematological malignancies, 2018: III. 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