Real-world treatment patterns and clinical characteristics of patients with t(11;14)-positive multiple myeloma.

Abstract

e23437 Background: Multiple myeloma (MM) patients harboring the t(11;14) translocation represent a distinct subtype with unique biological and clinical characteristics. While t(11;14)+ patients are increasingly being targeted in clinical studies, there is limited data on how they present in the community oncology setting. Here, we aimed to characterize renal function and treatment of t(11;14)+ patients using a large, geographically diverse real-world data platform. Methods: This retrospective cohort study leveraged deidentified electronic health records (EHRs) from the OMNY Health real-world data platform (2017-2025). Contributing health systems covered the Upper Midwest, Mid-Atlantic, and Southeast regions of the United States. Patients with cytogenetic evidence of t(11;14) translocation were selected and indexed at their first MM diagnosis. Estimated glomerular filtration rate (eGFR) in mL/min/1.73 m2 was calculated as the mean within 60 days (+/- 30 days) of the index date. Normal kidney function was defined as an eGFR > 90 mL/min/1.73 m². Mild and moderate kidney dysfunction were characterized by an eGFR threshold of < 90 and < 60 mL/min/1.73 m², respectively. Start of first-line (1L) therapy was assessed by reporting the administration patterns of Bortezomib, Lenalidomide, Daratumumab and Dexamethasone within 30 days following the index date. Results: A total of 52,984 encounters (102 unique patients) with a MM diagnosis and cytogenetic evidence of t(11;14) translocation were selected. Patients were predominately White (67.6%) and male (58.8%) with mean age of 64.9 (males) and 66.5 (females) years. Mean (standard deviation) eGFR among 48 evaluable patients was 57.1 (29.2) mL/min/1.73 m². 93.7% of patients had indication of kidney dysfunction (47.9% mild, 45.8% moderate) at diagnosis while 6.3% presented as normal. Among 45 patients receiving 1L therapy within 30 days of diagnosis, regimens were categorized as singlet (33.3%), doublet (40.0%) or triplet (26.7%). Mean time to regimen adjustment was longest for singlets (218.3 ± 312.6 days), followed by doublets (147.6 ± 392.4 days) and triplets (27.2 ± 46.3 days). Conclusions: We found a high rate of renal impairment in t(11;14)+ patients at the time of their first MM diagnosis and an inverse relationship between regimen intensity and time to adjustment. Together, these results lay a critical foundation for better understanding how t(11;14)+ patients are managed in routine clinical practice. Further research is needed to understand whether sociodemographic factors or other clinical characteristics are associated with initial treatment selection and time to regimen adjustment.