Multiple Myeloma – Unmet Need – Detailed, Expanded Analysis (US/EU) Relapse Or Refractory Third-line Multiple Myeloma
Multiple myeloma remains an incurable hematological malignancy despite the availability of numerous treatment options. Resistance to therapy is the primary challenge associated with the disease’s relapse and recurrence. The foremost goal in the third-line treatment of multiple myeloma is to extend patient survival. The mainstays of treatment combine multiple agents such as Bristol Myers Squibb’s Revlimid and Janssen’s Darzalex. Proteasome inhibitors such as Amgen / Ono Pharmaceutical’s Kyprolis and Takeda’s Ninlaro are also widely used. The emergence of Sanofi’s Sarclisa and Karyopharm’s Xpovio / Nexpovio has broadened the treatment options for high-risk patients in the third-line setting, but unmet need persists for more-effective therapies in this fragmented space.
QUESTIONS ANSWERED
- What treatment drivers and goals are most likely to influence the choice of third-line therapy in multiple myeloma?
- How do current therapies perform on key clinical drug attributes for this patient population?
- What are the prevailing areas of unmet need and hidden opportunities in this patient population?
- What trade-offs across clinical attributes and price are acceptable to surveyed hematologist-oncologists for a new therapy for third-line multiple myeloma?
PRODUCT DESCRIPTION
Unmet need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by Clarivate experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.
Markets covered: United States, United Kingdom, France, Germany
Primary research: Survey of 60 U.S. and 30 European hematologist-oncologists fielded in March 2022
Key companies: Janssen, Bristol Myers Squibb, Takeda, Amgen / Ono Pharmaceutical, Sanofi, Karyopharm Therapeutics
Key drugs: Darzalex, Revlimid, Ninlaro, Kyprolis, Pomalyst / Imnovid, Sarclisa, Xpovio / Nexpovio
Table of contents
- Multiple Myeloma - Unmet Need - Detailed, Expanded Analysis (US/EU) Relapse Or Refractory Third-line Multiple Myeloma
- Executive summary
- Unmet need - multiple myeloma - executive summary - March 2022
- Introduction
- Overview
- Methodology
- Rationale for treatment drivers and goals selection
- Rationale for drug selection
- Regimens for relapse or refractory third-line multiple myeloma and rationale for drug selection
- Treatment drivers and goals
- Key findings: attribute importance
- Relative importance of efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to surveyed hematologist-oncologists' prescribing decisions in relapsed or refractory third-line multiple myeloma
- Importance of efficacy attributes to prescribing decisions in relapsed or refractory third-line multiple myeloma: United States
- Importance of efficacy attributes to prescribing decisions in relapsed or refractory third-line multiple myeloma: Europe
- Importance of safety and tolerability attributes to prescribing decisions in relapsed or refractory third-line multiple myeloma: United States
- Importance of safety and tolerability attributes to prescribing decisions in relapsed or refractory third-line multiple myeloma: Europe
- Importance of convenience of administration attributes to prescribing decisions in relapsed or refractory third-line multiple myeloma: United States
- Importance of convenience of administration attributes to prescribing decisions in relapsed or refractory third-line multiple myeloma: Europe
- Key findings: stated vs. derived importance
- Stated vs. derived importance of key efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to prescribing decisions in relapsed or refractory third-line multiple myeloma: United States
- Stated vs. derived importance of key efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to prescribing decisions in relapsed or refractory third-line multiple myeloma: Europe
- Product performance against treatment drivers and goals
- Key findings
- Overall performance of key therapies for relapse or refractory third-line multiple myeloma: United States
- Overall performance of key therapies for relapse or refractory third-line multiple myeloma: Europe
- Mean overall performance of key therapies for relapsed or refractory third-line multiple myeloma: United States and Europe
- Relative performance of key therapies for relapsed or refractory third-line multiple myeloma across select efficacy attributes: United States
- Relative performance of key therapies for relapsed or refractory third-line multiple myeloma across select efficacy attributes: Europe
- Relative performance of key therapies for relapsed or refractory third-line multiple myeloma across select safety and tolerability attributes: United States
- Relative performance of key therapies for relapsed or refractory third-line multiple myeloma across select safety and tolerability attributes: Europe
- Relative performance of key therapies for relapsed or refractory third-line multiple myeloma across select convenience of administration attributes: United States
- Relative performance of key therapies for relapsed or refractory third-line multiple myeloma across select convenience of administration attributes: Europe
- Assessment of unmet need
- Key findings: unmet need in relapsed or refractory third-line multiple myeloma
- Surveyed hematologist-oncologistsu2019 satisfaction with the performance of key therapies for relapsed or refractory third-line multiple myeloma on efficacy, safety and tolerability, convenience of administration, and nonclinical factors: United States
- Surveyed hematologist-oncologistsu2019 satisfaction with the performance of key therapies for relapsed or refractory third-line multiple myeloma on efficacy, safety and tolerability, convenience of administration, and nonclinical factors: Europe
- Surveyed hematologist-oncologists' ascribed level of unmet need across key efficacy attributes in relapsed or refractory third-line multiple myeloma: United States
- Surveyed hematologist-oncologists' ascribed level of unmet need across key efficacy attributes in relapsed or refractory third-line multiple myeloma: Europe
- Surveyed hematologist-oncologists' ascribed level of unmet need across key safety and tolerability attributes in relapsed or refractory third-line multiple myeloma: United States
- Surveyed hematologist-oncologists' ascribed level of unmet need across key safety and tolerability attributes in relapse or refractory third-line multiple myeloma: Europe
- Surveyed hematologist-oncologists' ascribed level of unmet need across key convenience of administration attributes in relapse or refractory third-line multiple myeloma: United States
- Surveyed hematologist-oncologists' ascribed level of unmet need across key convenience of administration attributes in relapsed or refractory third-line multiple myeloma: Europe
- Key findings: unmet need in relapse or refractory third-line multiple myeloma and related indications
- Surveyed hematologist-oncologists' ascribed level of unmet need in relapsed or refractory third-line multiple myeloma and related indications: United States
- Surveyed hematologist-oncologists' ascribed level of unmet need in relapsed or refractory third-line multiple myeloma and related indications: Europe
- Opportunity analysis
- Areas of opportunity in the relapsed or refractory third-line multiple myeloma market and emerging therapy insights
- Opportunity: a novel therapy that extends overall survival
- Opportunity: a novel therapy that improves progression-free survival and overall response rate
- Opportunity: a novel therapy that improves minimal residual disease negativity
- Opportunity: a novel therapy that improves safety and tolerability
- Areas of opportunity in the relapsed or refractory third-line multiple myeloma market and emerging therapy insights
- Target product profiles
- Assessing drug development opportunities
- Target product profile methodology
- Attributes and attribute levels
- Assigned prohibitions for the conjoint module
- Attribute importance and part-worth utilities
- Relapse or refractory third-line multiple myeloma target product profile: attribute importance
- Median overall survival
- Median progression-free survival
- Overall response rate
- Minimal residual disease-negativity
- Incidence of grade 3/4 hematological toxicity
- Incidence of grade 3/4 cardiac toxicity
- Price per 28-day cycle
- Conjoint analysis-based simulation of a market scenario
- Relapse or refractory third-line multiple myeloma market simulation: share of preference of target product profiles included in the market scenario
- Relapse or refractory third-line multiple myeloma market simulation: likelihood to prescribe target product profiles included in the market scenario
- Relapse or refractory third-line multiple myeloma market simulation: target product profiles included in the market scenario
- Appendix
- Key abbreviations
- Bibliography
- Executive summary
Elliott Puttock, M.Res., Ph.D., is an analyst on the Oncology team at Clarivate. He has experience working in the pharmaceutical sector developing novel therapeutics for ongoing oncology projects. While earning his Ph.D., he specialized in metastatic ovarian cancer and focused on targeting the extracellular matrix to develop new treatments for patients. He obtained his doctorate from Barts Cancer Institute in London.