Survival shifts in multiple myeloma: Evaluating the impact of therapeutic advances and racial disparities after a decade of change.

Ahmed Hebishy Brody School of Medicine at East Carolina University, Greenville, NC info_outline Ahmed Hebishy, Joshua Walter Zweigle, Ali Hussain, Mahvish Muzaffar

Authors Ahmed Hebishy Brody School of Medicine at East Carolina University, Greenville, NC info_outline Ahmed Hebishy, Joshua Walter Zweigle, Ali Hussain, Mahvish Muzaffar Organizations Brody School of Medicine at East Carolina University, Greenville, NC Abstract Disclosures Research Funding No funding sources reported Background: Multiple myeloma (MM) is the second most common hematologic malignancy and is considered an incurable disease. However, the last two decades have witnessed the emergence of new therapies that have improved overall survival by several folds. In the current study, we are examining the evolving trends in age-adjusted incidence and relative survival among myeloma patients over the last 20 years, specifically focusing on discerning disparities in these trends based on racial classifications. Methods: We performed a retrospective cohort study using the SEER Plus Data, 12 registries, Nov 2022 Sub (1992-2020) to calculate the age-adjusted incidence and relative survival rate (RSR) of MM in the US in two specific time intervals 2001-2010 & 2011-2020 consistent with changes in MM treatment during 2011-2020 including the emergence of immunomodulatory drugs (IMiDs). The year of diagnosis, sex, and race data were available for each case. We excluded cases diagnosed before 2001 and after 2020. Patients were stratified by sex and categorized into two racial groups: White and Black. The 60-month (5-year) and 116-month (used as a 10-year estimate) RSR and age-adjusted incidence rate were calculated for the cohort and each racial group. We calculated survival utilizing the Kaplan-Meier method. Using the log-rank test, we also found hazard ratios (HR), with the corresponding CI for each racial group stratified by sex. Results: We investigated MM incidence and survival rate trends over two decades while considering gender and race. The age-adjusted incidence rate showed a significant overall increase from 6.5 to 7.4 per 100,000, with changes in gender-specific rates. Higher incidence rates among Black populations were noted. Cohort relative survival analysis revealed improved median survival (53 to 83 months) and increased relative survival rate both at five years (46.4% to 56.3%) and at ten years (28.8% to 40.8%). An investigation based on race revealed substantial improvements among both White and Black populations. The HR (Table) emphasized the improved survival outcomes for patients diagnosed in period two across genders and races. Conclusions: The study highlights the changes in the incidence and survival rates of MM. Notably, MM incidence has seen a significant rise in the last decade, particularly among the Black population. The survival of patients diagnosed between 2011 and 2020 revealed statistically significant improvement at both the 5- and 10-year mark compared to patients diagnosed between 2001 and 2010. White Males White Females Black Males Black Females HR 95% CI HR 95% CI HR 95% CI HR 95% CI 60 months 1.157 1.062 - 1.261 1.140 1.022 - 1.272 1.154 0.963 - 1.384 1.156 0.941 - 1.421 116 months 1.142 1.074 - 1.214 1.077 0.997 - 1.163 1.120 0.983 - 1.277 1.219 1.054 - 1.410