More than a third of patients diagnosed with multiple myeloma (MM) are over the age of 80, and yet most treatment successes have been reported in younger patients. However, patients over the age of 80 years received similar benefits as younger patients from MM treatment, according to a study reported online in the Journal of Geriatric Oncology.
Researchers identified 2,155 patients diagnosed with MM at age 80 years or older in the Surveillance, Epidemiology, and End Results Program (SEER)–Medicare database from 2007 to 2013. A cohort of 2,933 similar patients diagnosed with myeloma at age 70-79 was used for comparison.
The researcher found that the number of patients receiving treatment for myeloma within 6 months of diagnosis was significantly lower in the 80 years and older group, compared with the 70-79 years group. Only 51% of patients in the 80 years and older cohort received systemic treatment within 6 months following diagnosis, compared with 71% of patients in the 70-79 years cohort received systemic treatment in the same timeframe (P < .001)
The analysis showed that treatment was associated with an overall 26% decrease in hazard for death, independent of age, race, gender, poverty, comorbidities, and proxy measures of performance status. There was no statistically significant difference in treatment benefit based on age cohort (P = .610).
The median overall survival for patients diagnosed at age 80 years or older was 13.4 months, with those patients receiving systemic treatment having a median overall survival of 21.4 months, compared with 6.4 months for those not receiving treatment. In comparison, patients between ages 70 and 79 years had a median overall survival of 30.1 months with treatment.
The population over 80, when myeloma incidence peaks, is projected to triple over the next few decades, according to the researchers. “Antimyeloma treatment in the era of novel therapies seems to have a similar improvement on survival for the oldest-old, those beyond 80 years, as other patients. With growing knowledge of and experience with novel agents in older patients with myeloma, treatment rates have increased, which have in turn improved survival,” they concluded.
The study was funded by the National Cancer Institute. One author reported research funding from Janssen. The other authors had no relevant conflicts of interest.
SOURCE: Fiala MA et al. J Geriatric Oncol. 2020 Mar 10. doi.org/10.1016/j.jgo.2020.03.005.