Grant Number:	5U01CA265735-05 Interpret this number
Primary Investigator:	Chang, Su-Hsin
Organization:	Washington University
Project Title:	Comparative Modeling of Multiple Myeloma Across Myeloma Continuum: Prevention, Treatment, and Health Drivers
Fiscal Year:	2025

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 costliest, 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 potential benefits and harms of the novel interventions before implementation. It is also important to demonstrate the potential benefits and harms of de-implementation of the existing interventions, in lieu of the novel ones. 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 goal of reducing the health and economic burden of MM. 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 minimizing health and/or economic burden 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 or de-implementation of any outdated intervention; 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. 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.




High-Deductible Health Plans and Out-of-Pocket Health Care Costs Among Younger Patients With Multiple Myeloma.
Authors: Fiala M.A. , Ji M. , Slade M. , Huber J.H. , Shih Y.H. , Wang M. , Colditz G.A. , Wang S.Y. , Vij R. , Chang S.H. .
Source: Jco Oncology Practice, 2025-05-12 00:00:00.0; , p. OP2400978.
EPub date: 2025-05-12 00:00:00.0.
PMID: 40354593
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Cumulative Excess Body Mass Index and MGUS Progression to Myeloma.
Authors: Liu L. , Grandhi N. , Wang M. , Proskuriakova E. , Thomas T. , Schoen M.W. , Sanfilippo K.M. , Carson K.R. , Visram A. , Vachon C. , et al. .
Source: Jama Network Open, 2025-02-03 00:00:00.0; 8(2), p. e2458585.
EPub date: 2025-02-03 00:00:00.0.
PMID: 39918819
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Treatment Access among Younger Medicaid Beneficiaries with Multiple Myeloma.
Authors: Fiala M.A. , Ji M. , Shih Y.H. , Huber J. , Wang M. , Johnson K.J. , Gasoyan H. , Wang R. , Colditz G.A. , Wang S.Y. , et al. .
Source: Clinical Lymphoma, Myeloma & Leukemia, 2025 Feb; 25(2), p. 109-115.
EPub date: 2024-08-02 00:00:00.0.
PMID: 39209567
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Associations Between Patient Characteristics and Progression to Multiple Myeloma Among Patients With Monoclonal Gammopathy of Undetermined Significance: A Systematic Review.
Authors: Li Y. , Hsu S.H. , Wang R. , Theprungsirikul P. , Neparidze N. , Chang S.H. , Wang S.Y. .
Source: Clinical Lymphoma, Myeloma & Leukemia, 2024-12-06 00:00:00.0; , .
EPub date: 2024-12-06 00:00:00.0.
PMID: 39730300
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Association between glucagon-like peptide-1 receptor agonist use and progression of monoclonal gammopathy of uncertain significance to multiple myeloma among patients with diabetes.
Authors: Grandhi N. , Liu L. , Wang M. , Thomas T. , Schoen M. , Sanfilippo K. , Gao F. , Colditz G.A. , Carson K.R. , Janakiram M. , et al. .
Source: Jnci Cancer Spectrum, 2024-11-01 00:00:00.0; 8(6), .
PMID: 39514091
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Asymptomatic Incidence of Monoclonal Gammopathy of Undetermined Significance and Preclinical Duration to Myeloma Diagnosis: A Modeling Study.
Authors: Ji M. , Shih Y.H. , Huber J.H. , Wang M. , Feuer E.J. , Etzioni R. , Wang S.Y. , Chang S.H. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2024-08-06 00:00:00.0; , .
EPub date: 2024-08-06 00:00:00.0.
PMID: 39106151
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Racial differences in treatment and survival among older patients with multiple myeloma.
Authors: Wang R. , Neparidze N. , Ma X. , Colditz G.A. , Chang S.H. , Wang S.Y. .
Source: Cancer Medicine, 2024-01-17 00:00:00.0; , .
EPub date: 2024-01-17 00:00:00.0.
PMID: 38234237
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The Association of Agent Orange Exposure with the progression of monoclonal gammopathy of undetermined significance to multiple myeloma: a population-based study of Vietnam War Era Veterans.
Authors: Liu L.W. , Wang M. , Grandhi N. , Schroeder M.A. , Thomas T. , Vargo K. , Gao F. , Sanfilippo K.M. , Chang S.H. .
Source: Journal Of Hematology & Oncology, 2024-01-08 00:00:00.0; 17(1), p. 3.
EPub date: 2024-01-08 00:00:00.0.
PMID: 38191467
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Approaches to developing de novo cancer population models to examine questions about cancer and race in bladder, gastric, and endometrial cancer and multiple myeloma: the Cancer Intervention and Surveillance Modeling Network incubator program.
Authors: Sereda Y. , Alarid-Escudero F. , Bickell N.A. , Chang S.H. , Colditz G.A. , Hur C. , Jalal H. , Myers E.R. , Layne T.M. , Wang S.Y. , et al. .
Source: Journal Of The National Cancer Institute. Monographs, 2023-11-08 00:00:00.0; 2023(62), p. 219-230.
PMID: 37947329
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The Association of Agent Orange (AO) Exposure with Monoclonal Gammopathy of Undetermined Significance (MGUS) to Multiple Myeloma (MM) Progression: A Population-based Study of Vietnam War Era Veterans.
Authors: Liu L.W. , Wang M. , Grandhi N. , Schroeder M.A. , Thomas T. , Vargo K. , Gao F. , Sanfilippo K.M. , Chang S.H. .
Source: Research Square, 2023-10-09 00:00:00.0; , .
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Disentangling age, gender, and racial/ethnic disparities in multiple myeloma burden: a modeling study.
Authors: Huber J.H. , Ji M. , Shih Y.H. , Wang M. , Colditz G. , Chang S.H. .
Source: Nature Communications, 2023-09-20 00:00:00.0; 14(1), p. 5768.
EPub date: 2023-09-20 00:00:00.0.
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Mortality in the US Populations With Monoclonal Gammopathy of Undetermined Significance.
Authors: Ji M. , Huber J.H. , Schoen M.W. , Sanfilippo K.M. , Colditz G.A. , Wang S.Y. , Chang S.H. .
Source: Jama Oncology, 2023-09-01 00:00:00.0; 9(9), p. 1293-1295.
PMID: 37498610
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Natural Language Processing-Assisted Classification Models to Confirm Monoclonal Gammopathy of Undetermined Significance and Progression in Veterans' Electronic Health Records.
Authors: Wang M. , Yu Y.C. , Liu L. , Schoen M.W. , Kumar A. , Vargo K. , Colditz G. , Thomas T. , Chang S.H. .
Source: Jco Clinical Cancer Informatics, 2023 Sep; 7, p. e2300081.
PMID: 38048516
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A moment kernel machine for clinical data mining to inform medical decision making.
Authors: Yu Y.C. , Zhang W. , O'Gara D. , Li J.S. , Chang S.H. .
Source: Scientific Reports, 2023-06-28 00:00:00.0; 13(1), p. 10459.
EPub date: 2023-06-28 00:00:00.0.
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