Temporal Trends in Multiple Myeloma Mortality and Their Relationship to Evolving Treatment Strategies: A Retrospective Analysis Using SEER Data

Background: Multiple myeloma (MM) is the second most common hematologic malignancy, accounting for approximately 2% of cancer-related deaths in the United States. Over the past five decades, therapeutic advancements, including novel drug approvals and intensified treatment strategies, have significantly transformed MM management. This study examines temporal trends in MM-specific mortality and their association with evolving therapeutic approaches. Methods: This retrospective cross-sectional study utilized the Surveillance, Epidemiology, and End Results (SEER) database to evaluate age-adjusted MM mortality rates from 1975 to 2022. Annual Percent Change (APC) was calculated using Joinpoint regression analysis to identify significant shifts in mortality trends. The timeline of FDA-approved MM treatments was reviewed to explore potential temporal associations with mortality reductions. Results: MM mortality increased from 1975 to 1994 due to limited treatment options. The introduction of autologous stem cell transplantation in 1994 correlated with a modest decline. A marked decrease in mortality was observed from 2002 to 2009 with the emergence of immunomodulatory drugs and proteasome inhibitors, followed by significant reductions between 2014 and 2022 with the approval of multiple novel therapeutic agents. Stagnant mortality trends between 2009 and 2014 coincided with a period of no new drug class approvals. Conclusion: MM-specific mortality in the U.S. has declined substantially over the past two decades, reflecting the impact of novel therapies and frontline treatment intensification. The findings highlight MM’s epidemiologic transformation into a more manageable chronic condition. Addressing disparities in healthcare accessibility and costs is crucial to ensuring equitable treatment benefits for all patients.