ASH 2024: HealthTree Shares What Treatments Myeloma Patients Prefer

HealthTree’s real-world research on the generous participation of 747 multiple myeloma patients shows the importance of actively participating in self-advocacy. This year HealthTree had the opportunity to post the results of this project at the 66th American Society of Hematology (ASH) conferences. 

As a patient-focused foundation, it is essential to show findings that will accelerate the improvement of patient-centered care, that's why this research on patients' preferences in treatment shows insight into what matters to them 

What Would Multiple Myeloma Patients Prefer? 

As time progresses and more treatment advances arise, choosing a therapy becomes more complex for specialists and patients.To understand what myeloma patients prefer, the HealthTree Foundation collaborated with myeloma specialists Ghulam Rehman Mohyuddin, MD, and Rajshekhar Chakraborty, MD, to conduct a four-question survey through HealthTree Cure Hub. The survey presented patients with a hypothetical case in which they had to make a choice. 

The cases presented in the survey were the following: 

1. The first question presents patients with a choice between a three- or four-medication treatment for newly diagnosed multiple myeloma, which comes down to balancing benefits and risks. Both treatments offer a similar quality of life and overall survival after four years. However, the option with four medications helps delay disease progression, but the trade-off is a higher chance of infections and low white blood cell counts.

2. The decision in Question 2 focused on whether to choose a one-time treatment (like melphalan autograft) to deepen remission or to continue induction therapy once a week for four more months. The one-time treatment can cause significant side effects that may lower quality of life for about three months, but it improves the chances of staying cancer-free at five years (81% vs. 65%). However, both options lead to the same overall survival rate at five years.

3. This third question explored whether to use one or two medications for maintenance therapy. The option with two medications slightly improved the chances of staying in remission but it came with higher risks of side effects, including increased blood pressure, fevers, and potential heart problems.

4. The last question presented a treatment option that extended the time before the disease progressed by about two months but did not improve overall survival. It also came with an increased risk of side effects, requiring patients to weigh the potential benefit against the added risks.

What Are the Survey’s Results? 

Of a total of 747 people who answered the survey, a median age was 66 years old, most of whom were female (59%) and white (91%). Among those who provided complete diagnostic information (405 people), 83% were diagnosed with multiple myeloma (MM), and 17% had precursor conditions (like smoldering myeloma or MGUS). Notably, the responses from these two groups were very similar.

Key Findings on Patient Treatment Choices

• Choosing Between a 3 or 4-Medication Induction Therapy

  • About half (51%) preferred the option with 4 medications, which offers a longer period before the disease progresses (PFS) but has a higher risk of side effects.

  • The remaining 49% opted for the option with 3 medications, which has fewer side effects but a slightly shorter PFS.

• One-Time Consolidation vs. Weekly Treatment to Deepen Response

  • 47% chose a one-time treatment option that could cause three months of side effects but might deepen remission.

  • Slightly more participants (53%) preferred continuing weekly therapy for four months, avoiding the intense side effects of the one-time treatment.

• Maintenance Therapy with 1 vs. 2 medications

  • A large majority (84%) chose a single medication maintenance therapy, even though it offers a shorter remission period, as it has fewer risks and side effects.

  • Only 16% opted for two medications, which provide a longer remission period but come with a higher likelihood of side effects like high blood pressure and heart-related issues.

• Treatment for Relapsed Disease

  • When offered a treatment that extended remission by two months but did not improve overall survival, 93% of participants avoided it, prioritizing their quality of life.

The Importance of Understanding Patient Preferences

The study highlights that patients prioritize quality of life and diminished side effects over modest improvements in remission duration (PFS), especially when overall survival (OS) remains unchanged.

• Balanced decisions for induction therapy and consolidation treatments: for early treatment options like induction (3 medications vs. 4 medications) or one-time consolidation, preferences were split, showing diverse priorities.

• Preference for options with fewer side effects in maintenance and relapsed disease: most participants opted for less aggressive treatments in maintenance and for multiply relapsed disease, favoring quality of life over extended remission.

These insights are invaluable for doctors, researchers, and regulators as they aim to design patient-centered clinical trials and treatments, ensuring that future therapies align with what matters most to patients.

If you also want to contribute to patient-focused research and real-world data that provides insight into patient preferences, create a free HealthTree account where you can access different surveys, keep track of your disease, and use all of our amazing free resources! 

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We’re excited to cover this important information for you so it’s comprehensive and that way you can stay updated on what can affect and benefit your life. You can bookmark the link below to catch up on news about HealthTree’s conference coverage at ASH24. 

Source: 

• 2281 Patient Preferences on Clinical Decision-Making in Myeloma: A 747-Patient Survey