Connect MM Registry: The Importance of Establishing Baseline Disease Characteristics.

BACKGROUND Connect MM is the first and largest observational, noninterventional, prospective registry of patients newly diagnosed with multiple myeloma (NDMM) in the United States. It collects longitudinal data on patients within clinical practice including patients in clinical trials. PATIENTS AND METHODS Of the 1513 patients enrolled, 1493 were protocol-eligible. RESULTS Median age was 67 years, 81.9% (1223/1493) were Caucasian, and 57.2% (854/1493) were male. Of these patients, 26.5% (232/877) were International Staging System stage I, 34.9% (306/877) stage II, and 38.7% (339/877) stage III. Eastern Cooperative Oncology Group performance status of 0/1/2 were reported in 96.6% (1017/1053). Clonal plasma cells > 10% were found in 91.6% (1282/1399) of patients and M-component in 98.8% (1343/1359). Hypercalcemia was present in 7.3% (108/1481) of patients, serum creatinine > 2 mg/dL in 18.3% (271/1484), anemia in 45.1% (673/1493), and bone involvement in 76.7% (1143/1490). Of the 15 National Comprehensive Cancer Network (NCCN) recommended diagnostic tests, a median of 12 were performed. Lactate dehydrogenase assessment, serum free light chain ratio, and immunofixation were reported in 38.4% (574/1493), 62.1% (927/1493), and 66% (985/1493) of patients, respectively. Quantitative immunoglobulin, β-2 microglobulin, and protein electrophoresis (serum or urine) were reported in 72.3% (1080/1493), 74.1% (1107/1493), and 78.0% (1164/1493) of patients, respectively. Bone marrow biopsy was reported in 92.2% (1376/1493), but conventional cytogenetic and fluorescence in situ hybridization analysis were reported in only 63.2% (944/1493) and 59.8% (893/1493) of patients, respectively. A high-risk cytogenetic profile (according to International Myeloma Working Group [IMWG] criteria) was found in 16.9% (253/1493). CONCLUSION This analysis provides insight into the demographic and disease characteristics of NDMM patients in a range of clinical practices. Creating solid records of baseline patient disease characteristics using suggested NCCN diagnostic work-up and IMWG criteria provides a foundation for monitoring disease progression and response to treatment.

[1]  B. Barlogie,et al.  International uniform response criteria for multiple myeloma , 2006, Leukemia.

[2]  H. Goldschmidt,et al.  IMWG consensus on risk stratification in multiple myeloma , 2014, Leukemia.

[3]  J. Crowley,et al.  International staging system for multiple myeloma. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  M. Levine,et al.  Registries that show efficacy: good, but not good enough. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  F. Prósper,et al.  Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. , 2013, The New England journal of medicine.

[6]  R A Kyle,et al.  Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma , 2009, Leukemia.

[7]  R. Branson,et al.  African Americans' participation in clinical research: importance, barriers, and solutions. , 2007, American journal of surgery.

[8]  M. Pericak-Vance,et al.  Recruiting intergenerational African American males for biomedical research Studies: a major research challenge. , 2011, Journal of the National Medical Association.

[9]  R. Kyle,et al.  Drug therapy: Multiple myeloma , 2004 .

[10]  S. Jagannath,et al.  Identifying professional education gaps and barriers in multiple myeloma patient care: findings of the Managing Myeloma Continuing Educational Initiative Advisory Committee. , 2014, Clinical lymphoma, myeloma & leukemia.

[11]  J. H. Lee,et al.  Clinical profiles of multiple myeloma in Asia—An Asian Myeloma Network study , 2014, American journal of hematology.

[12]  M Boccadoro,et al.  International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders , 2009, Leukemia.

[13]  O. Landgren Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma: biological insights and early treatment strategies. , 2013, Hematology. American Society of Hematology. Education Program.

[14]  H. Goldschmidt,et al.  Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[15]  T. Chou Multiple myeloma : recent progress in diagnosis and treatment. , 2012, Journal of clinical and experimental hematopathology : JCEH.

[16]  Kenneth C. Anderson,et al.  Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group , 2003, British journal of haematology.

[17]  M. Weinblatt,et al.  Use of data from multiple registries in studying biologic discontinuation: challenges and opportunities. , 2013, Clinical and experimental rheumatology.

[18]  I. Turesson,et al.  Patterns of improved survival in patients with multiple myeloma in the twenty-first century: a population-based study. , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  V. Pavone,et al.  A Simple Score, Based On Geriatric Assessment, Improves Prediction of Survival, and Risk Of Serious Adverse Events In Elderly Newly Diagnosed Multiple Myeloma Patients , 2013 .

[20]  T. Therneau,et al.  Racial disparities in the prevalence of monoclonal gammopathies: a population-based study of 12 482 persons from the National Health and Nutritional Examination Survey , 2014, Leukemia.

[21]  Lust,et al.  Trisomies in multiple myeloma: impact on survival in patients with high-risk cytogenetics. , 2012, Blood.

[22]  J. Ashman,et al.  Compliance with National Comprehensive Cancer Network guidelines in the use of radiation therapy for extremity and superficial trunk soft tissue sarcoma in the United States , 2014, Journal of surgical oncology.

[23]  M. Dimopoulos,et al.  Extensive bone marrow infiltration and abnormal free light chain ratio identifies patients with asymptomatic myeloma at high risk for progression to symptomatic disease , 2013, Leukemia.

[24]  Clinical Features and Survival Outcomes in Patients with Multiple Myeloma: Analysis of Web-Based Data from the Korean Myeloma Registry , 2009, Acta Haematologica.

[25]  R. Kyle,et al.  Haematological cancer: Treatment of smoldering multiple myeloma , 2013, Nature Reviews Clinical Oncology.

[26]  J. Norton,et al.  Failure to comply with NCCN guidelines for the management of pancreatic cancer compromises outcomes. , 2012, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[27]  M. Dimopoulos,et al.  Initial Phase 3 Results Of The First (Frontline Investigation Of Lenalidomide + Dexamethasone Versus Standard Thalidomide) Trial (MM-020/IFM 07 01) In Newly Diagnosed Multiple Myeloma (NDMM) Patients (Pts) Ineligible For Stem Cell Transplantation (SCT) , 2013 .

[28]  M. Pericak-Vance,et al.  African American participation in health-related research studies: indicators for effective recruitment. , 2013, Journal of public health management and practice : JPHMP.

[29]  Terry M Therneau,et al.  Review of 1027 patients with newly diagnosed multiple myeloma. , 2003, Mayo Clinic proceedings.

[30]  S. Salmon,et al.  A clinical staging system for multiple myeloma correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival , 1975, Cancer.

[31]  E Terpos,et al.  International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma , 2009, Leukemia.

[32]  C. Counsell,et al.  Limitations of using a cancer registry to identify incident primary intracranial tumours , 1997, Journal of neurology, neurosurgery, and psychiatry.

[33]  K. Robison,et al.  Adherence Patterns to National Comprehensive Cancer Network Guidelines for Referral of Women With Breast Cancer to Genetics Professionals , 2016, American journal of clinical oncology.

[34]  J. H. Lee,et al.  Management of multiple myeloma in Asia: resource-stratified guidelines. , 2013, The Lancet. Oncology.