{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T07:03:21Z","timestamp":1768547001560,"version":"3.49.0"},"reference-count":44,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III (ISCIII)","award":["FIS PI22\/00647"],"award-info":[{"award-number":["FIS PI22\/00647"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["ICI19\/00025"],"award-info":[{"award-number":["ICI19\/00025"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["2021SGR01292"],"award-info":[{"award-number":["2021SGR01292"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["LABAE21971FERN"],"award-info":[{"award-number":["LABAE21971FERN"]}]},{"DOI":"10.13039\/501100004587","name":"European Union","doi-asserted-by":"publisher","award":["FIS PI22\/00647"],"award-info":[{"award-number":["FIS PI22\/00647"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"European Union","doi-asserted-by":"publisher","award":["ICI19\/00025"],"award-info":[{"award-number":["ICI19\/00025"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"European Union","doi-asserted-by":"publisher","award":["2021SGR01292"],"award-info":[{"award-number":["2021SGR01292"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"European Union","doi-asserted-by":"publisher","award":["LABAE21971FERN"],"award-info":[{"award-number":["LABAE21971FERN"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003030","name":"AGAUR; Generalitat de Catalunya","doi-asserted-by":"publisher","award":["FIS PI22\/00647"],"award-info":[{"award-number":["FIS PI22\/00647"]}],"id":[{"id":"10.13039\/501100003030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003030","name":"AGAUR; Generalitat de Catalunya","doi-asserted-by":"publisher","award":["ICI19\/00025"],"award-info":[{"award-number":["ICI19\/00025"]}],"id":[{"id":"10.13039\/501100003030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003030","name":"AGAUR; Generalitat de Catalunya","doi-asserted-by":"publisher","award":["2021SGR01292"],"award-info":[{"award-number":["2021SGR01292"]}],"id":[{"id":"10.13039\/501100003030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003030","name":"AGAUR; Generalitat de Catalunya","doi-asserted-by":"publisher","award":["LABAE21971FERN"],"award-info":[{"award-number":["LABAE21971FERN"]}],"id":[{"id":"10.13039\/501100003030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Asociaci\u00f3n Espa\u00f1ola Contra el Cancer (AECC)","award":["FIS PI22\/00647"],"award-info":[{"award-number":["FIS PI22\/00647"]}]},{"name":"Asociaci\u00f3n Espa\u00f1ola Contra el Cancer (AECC)","award":["ICI19\/00025"],"award-info":[{"award-number":["ICI19\/00025"]}]},{"name":"Asociaci\u00f3n Espa\u00f1ola Contra el Cancer (AECC)","award":["2021SGR01292"],"award-info":[{"award-number":["2021SGR01292"]}]},{"name":"Asociaci\u00f3n Espa\u00f1ola Contra el Cancer (AECC)","award":["LABAE21971FERN"],"award-info":[{"award-number":["LABAE21971FERN"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The proportion of non-transplant-eligible (NTE) newly diagnosed multiple myeloma (NDMM) patients excluded from clinical trials (CTs) and their prognosis is unknown. CT results may not be generalizable to real-world practice due to strict recruitment criteria. We analyzed causes of NTE-NDMM patient exclusion form CTs and their outcomes. A total of 211 NTE-NDMM patients were included. They were divided into three periods: 2003\u20132007, 2008\u20132012, and 2013\u20132017. Overall, 50% received non-trial treatment (NCT), while 50% participated in a CT (20% control group (CG) and 30% experimental group (EG)). Main causes for exclusion from CTs were comorbidities, ECOG &gt; 2, and renal insufficiency. In the first two periods, the CR rate was similar regardless of treatment type, but in the last period, the EG group showed improved CR. Median PFS was similar in the first two periods, with a benefit seen only in the EG in the last period. The median OS was significantly longer in CT-included patients compared to NCT group in the last two periods. Conclusions: The presence of comorbidities and worsened ECOG were the main reasons for CT exclusion. Patients included in CTs had a longer OS than NCT. This OS benefit may be influenced by a selection bias, making it challenging to generalize CT results to real clinical practice.<\/jats:p>","DOI":"10.3390\/cancers15215261","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T09:28:13Z","timestamp":1698917293000},"page":"5261","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of Patients with Newly Diagnosed Transplant-Ineligible Multiple Myeloma According to Clinical Trials Enrollment: Experience of a Single Institution"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5694-0921","authenticated-orcid":false,"given":"Luis Gerardo","family":"Rodr\u00edguez-Lobato","sequence":"first","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Tovar","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7568-2527","authenticated-orcid":false,"given":"Anna","family":"de Daniel","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4930-9255","authenticated-orcid":false,"given":"Carlos","family":"Fern\u00e1ndez de Larrea","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Teresa","family":"Cibeira","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Jim\u00e9nez-Segura","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1752-3081","authenticated-orcid":false,"given":"David F.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aina","family":"Oliver-Cald\u00e9s","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Blad\u00e9","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2534-9239","authenticated-orcid":false,"given":"Laura","family":"Rosi\u00f1ol","sequence":"additional","affiliation":[{"name":"Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Cl\u00ednic of Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1002\/ijc.22718","article-title":"Multiple myeloma: A review of the epidemiologic literature","volume":"120","author":"Alexander","year":"2007","journal-title":"Int. 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