||5U01CA265735-02 Interpret this number
||Comparative Modeling of Multiple Myeloma Across Myeloma Control Continuuum: Prevention, Treatment, and Disparity Reduction
Multiple myeloma (MM) is a common and lethal hematologic malignancy. Treatments of MM have been rapidly
evolving. While these new treatments improve survival considerably, the median survival still ranges from 43-
83 months at diagnosis. Among all cancer sites, the management of MM is the most costly, which in part can
be attributable to guideline recommended multidrug regimens. Despite such significant health and economic
burdens and rapid changing landscape for MM treatments, MM is not one of the cancer sites in the Cancer
Intervention and Surveillance Modeling Network (CISNET). Therefore, MM lacks comparative modeling to set
goals and policy prioritization in MM prevention and control. Moreover, unlike breast cancer or colorectal
cancer, there exists no population-based screening for MM or risk managed strategies for those with
premalignant conditions (MGUS and smoldering MM). MM requires comparative modeling to evaluate
promising intervention strategies, particularly at premalignant stages. To prevent/control this devastating
disease, it is imperative to demonstrate the potentials of these interventions before implementation. Moreover,
marked racial disparities in MM (both incidence and survival) is long-established. Without any value-based
strategies for prevention and treatment, MM health disparities will continue to worsen. This Incubator Program
will include two modeling groups to conduct comparative modeling under the coordination of the coordinating
center. Our Program will evaluate novel strategies in preventing or treating MM with the goals of reducing the
burden of MM and mitigating MM disparities. We plan to comparatively build, calibrate, and validate evidence-
based MM modeling across the MM care continuum (Aim 1). Using the proposed comparatively modeling, we
will (1) assess the impacts of novel MM prevention strategies in high-risk patients diagnosed with MGUS (Aim
2); (2) evaluate the cost-effectiveness of novel treatment regimens as well as guideline-recommended
treatments in patients diagnosed with MM (Aim 3); and (3) assess whether, under what conditions, and in
which ways the goal of eliminating racial disparities can be achieved through the proposed novel intervention
strategies (Aim 4). The proposed MM Incubator Program is significant in its capability to 1) build evidence-
based comparative modeling for MM, a disease area that lacks of such modeling, relative to the areas of solid
tumors already with such modeling, to guide interventions and policies; 2) provide evidence-based evaluation
before implementation of any costly clinical trial; 3) explore novel interventions/treatments at various stages of
MM; and 4) examine the value of guideline-recommended therapies, providing evidence to inform changes in
guidelines and thus a shift in current clinical practice of MGUS and MM management. The proposed
intervention strategies for MGUS and MM patients are innovative, with the goals to prevent and control MM
and reduce MM disparities. Successful completion of this study will provide evidence in tangible metrics to urge
a paradigm shift from current MGUS/MM management. It is therefore a vital step to move the field forward.
Disentangling age, gender, and racial/ethnic disparities in multiple myeloma burden: a modeling study.
, Ji M.
, Shih Y.H.
, Wang M.
, Colditz G.
, Chang S.H.
Nature communications, 2023-09-20; 14(1), p. 5768.
A moment kernel machine for clinical data mining to inform medical decision making.
, Zhang W.
, O'Gara D.
, Li J.S.
, Chang S.H.
Scientific reports, 2023-06-28; 13(1), p. 10459.