Page 240 - Haematologica Vol. 110 - January 2025

LETTER TO THE EDITOR
with increased treatment accessibility.
In conclusion, this is one the largest population-level studies highlighting the significant efficacy-effectiveness gap between registrational RCT and RW usage of these regimens, with RW patients experiencing a 51% higher risk of progression or death, and a 76% higher risk of death compared to RCT patients. Future studies focusing on clos- ing the efficacy-effectiveness gap may involve designing trials that better represent RW scenarios using pragmatic trial designs, or more inclusive eligibility criteria. Our data emphasize the importance of ongoing evaluation of RW data to further contextualize effectiveness of therapy and facilitate shared treatment decisions among patients and clinicians.
Authors
Alissa Visram,1 Kelvin Kar-Wing Chan,2 Hsien Seow,3 Gregory Pond,3 Anastasia Gayowsky,4 Ghulam Rehman Mohyuddin,5 Arleigh McCurdy,1 Irwindeep Sandhu,6 Christopher Venner,7 Guido Lancman,8 Amaris Balitsky,3 Tom Kouroukis,3 Robert Bruins,9 Shaji Kumar,10 Rafael Fonseca11 and Hira Mian3
1The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; 2Department of Medicine, Sunnybrook Health Sciences Center, University of Toronto, Ontario, Canada; 3Department of Oncology, McMaster University, Hamilton, Ontario, Canada; 4ICES McMaster, McMaster University, Hamilton, Ontario, Canada; 5Department of Hematology, Huntsman Cancer Institute, Salt Lake City, UT, USA; 6Department of Oncology, University of Edmonton, Edmonton, Alberta, Canada; 7Department of Medical Oncology, BC Cancer - Vancouver Center, University of British Columbia, Vancouver, British Columbia, Canada; 8Department of Medicine, University of Toronto, Toronto, Ontario, Canada; 9Eli Lilly Canada Inc., Toronto, Ontario, Canada; 10Division of Hematology, Mayo Clinic, Rochester, MI, USA and 11Division of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, USA
Correspondence:
A. VISRAM - alisvisram@toh.ca
https://doi.org/10.3324/haematol.2024.285768
References
1. Facon T, Dimopoulos MA, Dispenzieri A, et al. Final analysis of survival outcomes in the phase 3 FIRST trial of up-front treatment for multiple myeloma. Blood. 2018;131(3):301-310.
2. Durie BGM, Hoering A, Sexton R, et al. Longer term follow-up of the randomized phase III trial SWOG S0777: bortezomib, lenalidomide and dexamethasone vs. lenalidomide and dexamethasone in patients (Pts) with previously untreated multiple myeloma without an intent for immediate autologous stem cell transplant (ASCT). Blood Cancer J. 2020;10(5):53.
3. Dimopoulos MA, Moreau P, Palumbo A, et al. Carfilzomib and
Received: May 1, 2024. Accepted: August 16, 2024. Early view: August 22, 2024.
©2025 Ferrata Storti Foundation Published under a CC BY-NC license
Disclosures
No conflicts of interest to disclose.
Contributions
Conception and design by AV, HM and HS. Data collection by AG and RB. Analysis and interpretation of data, manuscript writing and approval of the final article by all authors.
Acknowledgments
We thank IQVIA Solutions Canada Inc. for use of their Drug Information File. Parts of this material are based on data and/or information compiled and provided by CIHI, the Ontario Ministry of Health, and Ontario Health (OH). The analyses, conclusions, opinions and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred.
Funding
This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). This study also received funding from Myeloma Canada.
Data-sharing statement
The dataset from this study is held securely in coded form at ICES. While legal data sharing agreements between ICES and data providers (e.g., healthcare organizations and government) prohibit ICES from making the dataset publicly available, access may be granted to those who meet prespecified criteria for confidential access, available at www.ices.on.ca/DAS (email: das@ices.on.ca). The full dataset creation plan and underlying analytic code are available from the authors upon request, understanding that the computer programs may rely upon coding templates or macros that are unique to ICES and are therefore either inaccessible or may require modification.
dexamethasone versus bortezomib and dexamethasone for patients with relapsed or refractory multiple myeloma (ENDEAVOR): a randomised, phase 3, open-label, multicentre study. Lancet Oncol. 2016;17(1):27-38.
4. Stewart AK, Rajkumar SV, Dimopoulos MA, et al. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. N Engl J Med. 2015;372(2):142-152.
5. Mateos MV, Sonneveld P, Hungria V, et al. Daratumumab, bortezomib, and dexamethasone versus bortezomib and dexamethasone in patients with previously treated multiple
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