INTRODUCTION: Multiple myeloma (MM) is the second most common hematological malignancy in the United States (US), representing 1.4% of all newly diagnosed cancers. The annual number of new MM patients is expected to increase primarily because the population is ageing. In parallel, several new drugs with unprecedented efficacy have been approved by the FDA. We were motivated to use data from the Surveillance, Epidemiology, and End Results (SEER) Program and statistical models to estimate future numbers of MM survivors in the era of modern therapy.
METHODS: We estimated future MM incidence using age-period-cohort forecasting models. We estimated all-cause mortality rates by years-since-MM-diagnosis, for cohorts of incident cases defined by age-at-diagnosis and year-of-diagnosis; here we used a proportional hazards absolute risk model with age, year, and duration effects specified using linear splines. We calculated current and future prevalence rates based on observed and extrapolated SEER incidence and mortality. We calculated corresponding numbers of MM survivors in the US by multiplying prevalence rates by official observed and projected population counts. We projected life year gains among persons with MM from prevalence forecasts incorporating more and less favorable assumptions about MM prognosis.
RESULTS: We analyzed MM among black and white men and women using 1992 - 2010 SEER data and forecast to 2022. Qualitative patterns were similar in each group. As previously reported, incidence was stable or slightly increasing and highest among black men. However, survival improved in all groups between 1992 through 2010. For example, among white men aged 60-69 years at diagnosis, median survival after MM increased from 2.6 to 5.0 years. If progress continues at the same rate - a conservative assumption in light of recent advances - the projected median will increase to 7.6 years circa 2022. Among black and white men and women ages 40 - 79 years combined, the number of new MM cases is expected to increase by 28%, from 16,000 to 21,000, primarily because of population growth. However, the number of persons living with MM is conservatively expected to increase by 55%, from 76,000 to 119,000, because of improvements in prognosis as well as population growth. The cumulative life year gain between 2011 through 2022 is around 50,000 life years. If recent treatments are as promising as they appear, these estimates will be conservative.
CONCLUSION: Driven by access to modern therapies with unprecedented efficacy, overall survival for patients with MM will continue to improve significantly. Consequently, our forecast is MM will become much more common in the era of modern therapy. The numbers of patients living with MM are expected to increase more quickly than the corresponding numbers of new cases.
Citation Format: Philip S. Rosenberg, Ana Best, William F. Anderson, Ola Landgren. Multiple myeloma will become a common cancer in the era of modern therapy. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 5231.