Racial differences in the survival of elderly patients with multiple myeloma in pre- and post-novel agent era

Objective: To evaluate racial differences in the survival of elderly myeloma patients in the pre- and post-novel agent era. Materials and Methods: We conducted this study to compare five-year relative survival rates (RS) of elderly patients with multiple myeloma in pre-novel (1991-2002) and post-novel (2007-2011) agent era based on ethnicity utilizing the Surveillance, Epidemiology, and End Results (SEER-18) database. Results: The database comprised of 23,318 patients (13,179 in the pre- and 10,139 in the post-novel agent era). The 5-year RS was significantly better in the post-novel agent era (36.3-39.6 vs. 24.2-25.9, Z-score = 16.4, p = 0.0001). There was significant survival benefit in post-novel agent era for both males and females and also for Caucasians and African Americans (< 80 years of age). However, there was no improvement in survival for African Americans who were >= 80 years of age. Conclusions: The survival benefit in the period 2007-2011 is likely due to the introduction of novel agents. A lack of survival benefit for the very elderly African-American is a concerning finding. We therefore recommend further study to explore the causes of this racial disparity. (C) 2016 Elsevier Ltd. All rights reserved.