Racial Disparities in Use of Multiple Myeloma Therapies
By: Meg Barbor, MPH
Posted: Monday, February 12, 2018
Although outcomes in multiple myeloma have improved considerably, disparities among racial and ethnic groups still exist. According to research published by Sikander Ailawadhi, MD, of Mayo Clinic Florida, and colleagues, in Cancer Medicine, differences in the use of novel therapeutics might be to blame.
“We noted considerable variability in multiple myeloma therapeutics utilization with seeming inequity for racial‐ethnic minorities,” the investigators revealed. “These trends should be considered to eliminate drug access and utilization disparities and achieve equitable benefit of therapeutic advances across all races.”
Using the Surveillance, Epidemiology, and End Results Program–Medicare database, the researchers performed a utilization analysis of lenalidomide, thalidomide, bortezomib, and stem cell transplant among 5,338 patients diagnosed with multiple myeloma between 2007 and 2009.
Among African American patients, significantly lower use of lenalidomide was observed, whereas higher thalidomide use was recorded among Hispanic and Asian patients. Lower bortezomib use was noted among Asian patients, whereas Hispanic patients had the highest median number of days to first dose of bortezomib and the lowest use of stem cell transplant. Hispanic and Asian patients were the only groups without notable increases in lenalidomide and bortezomib use, respectively.
Stem cell transplant within the first year after diagnosis was associated with better overall survival, and stem cell transplant increased over time for all groups except African American patients. Meanwhile, bortezomib use was associated with inferior survival.