Posted: Friday, May 5, 2023
Ludovic Saba, MD, of the Cleveland Clinic Florida Foundation, Weston, and colleagues conducted a retrospective analysis to evaluate the demographic and socioeconomic determinants that may affect access to multiagent therapy among patients with multiple myeloma. The results of their study, which were presented during the American Association for Cancer Research (AACR) Annual Meeting 2023 (Abstract 1936/10), revealed five potential disparity factors that impact treatment options and outcomes—race and ethnicity, facility type, insurance status, median household income, and level of education.
“In this large analysis of multiple myeloma patients, we identified that Non-Hispanic Black patients and those with a lower socioeconomic status were less likely to receive the standard-of-care multiagent therapy in this large cohort of real-world data set from across the USA,” the investigators concluded. “These results further corroborate the need to provide equitable access to care, which will translate to better clinical outcomes.”
The National Cancer Database was queried to identify 171,261 patients diagnosed with multiple myeloma from 2004 to 2017. To determine predictive factors for receiving multiagent therapy and survival on multiagent therapy, multivariate logistic and Cox regression analyses were performed, respectively.
Compared with non-Hispanic White patients, non-Hispanic Black patients had lower odds of receiving multiagent therapy (P < .0001). Of note, Hispanic Black patients had higher odds than non-Hispanic Black patients (P = .01) of receiving multiagent therapy. Patients who were treated in academic centers, on Medicare or Medicaid, of lower median household income (P < .0001), and with lower levels of education (P = .0133) were less likely to be treated with multiagent regimens.
A significant survival benefit among patients who received multiagent therapy was demonstrated by Kaplan-Meier survival curves. Furthermore, the data showed that when Black and Hispanic patients received multiagent therapy for myeloma, they seemed to have better outcomes than White and non-Hispanic patients (P < .0001).
Disclosure: The study authors reported no conflicts of interest.