P-179 Altered Lipid Metabolism in IMiD/CELMoD Resistant Multiple Myeloma Confers Novel and Targetable Vulnerabilities

2017 to 2022. Treatment drop-out decreased in 2L to 3L and 3L to 4L+, with a drop-out rate of 17% and 19% per switch subgroup, respectively, in 2022. Main 1L regimens in SCT-E (VCd and VTd) and SCT-NE subgroups (VMP and VCd) remained stable, with daratumumab-based regimens increase in 2022 in all subgroups.Patient share in maintenance therapy increased from 5% to 16% in the overall treated population, dominated by lenalidomide in 2022.The 2L and 3L treatment pattern changed considerably, with daratumumab-based regimens dominating patient share in 2022 (2L-43%; 3L-35%).In 4L+ a heterogenous treatment pattern emerged, with no standard of care identified, being carfilzomib-and daratumumab-based regimens the most relevant in 2022.Overall median TD increased in SCT-E subgroup from 5 to 19 months between time series, driven by maintenance therapy, and remained stable for SCT-NE patients (10 months).Regarding TTNT, median time increased between 3L to 4L+ in SCT-E patients from 5.5 to 9 months.Conclusions: MM treatment landscape changed during a 5-year period, characterized by an increase in treated patients, patients achieving advanced treatment lines, and improved access to therapeutic innovation in earlier treatment stages of the disease.