Multiple myeloma is an incurable hematological malignancy despite the availability of several treatment options. Resistance to therapy is the primary treatment challenge associated with relapse and recurrence, especially in elderly patients. The foremost goal in the third-line treatment of multiple myeloma is extending patients’ survival. The mainstays of treatment are agents that affect the immune system, such as Celgene’s Revlimid and Pomalyst / Imnovid used in combination with the generic corticosteroid dexamethasone. The launch of the proteasome inhibitor Kyprolis (Amgen / Ono Pharmaceutical) and the emergence of novel drugs including Bristol-Myers Squibb / AbbVie’s Empliciti and Janssen’s Darzalex are impacting treatment choices in the third-line setting. However, in the absence of a uniform treatment regimen, the choice of third-line therapy for multiple myeloma patients is varied.


  • What are the treatment drivers and goals for third-line multiple myeloma?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for third-line multiple myeloma?
  • What are the prevailing areas of unmet need and opportunity in third-line multiple myeloma?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European hematologist-oncologists for a hypothetical new third-line multiple myeloma drug?


Unmet Need provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 61 U.S. and 30 European hematologist-oncologists fielded in December 2018

Key companies: Janssen, Celgene, Amgen / Ono Pharmaceutical, Bristol-Myers Squibb / AbbVie

Key drugs: Darzalex, Revlimid, Empliciti, Ninlaro, Kyprolis, Pomalyst / Imnovid

Table of contents

  • Detailed, Expanded Analysis: Third-Line Multiple Myeloma
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Rationale for Drug Selection
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Key Findings: Stated vs. Derived Importance
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Third-Line Multiple Myeloma
      • Key Findings: Unmet Need in Third-Line Multiple Myeloma and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the Third-Line Multiple Myeloma Market and Emerging Therapy Insights
        • Opportunity: A New Therapy for Improving Prolonged Overall Survival
        • Opportunity: A Novel Regimen with Improved Safety and Tolerability
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Third-Line Multiple Myeloma Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Scenario 1
        • Scenario 2
    • Appendix
      • Bibliography

Author(s): Snigdha Gupta, Ph.D

Dr. Snigdha Gupta is a Lead Analyst in the oncology team at Decision Resources Group with expertise in multiple oncology indications including non-small cell lung cancer and multiple myeloma. Prior to joining DRG, Dr. Snigdha Gupta was a subject matter expert in immune-oncology, autoimmunity and dealt in generating in-depth framework based scientific analyses for client projects. In her previous organizations, she was involved in the planning and execution of the IND enabling preclinical studies. She has been instrumental in the stage-up of two small molecules at Bioxcel Therapeutics and Daiichi Sankyo Pharma India Pvt. Ltd. Dr. Gupta holds in infectious diseases from the Indian Institute of Chemical Biology, Jadavpur University, Kolkata while her post-doctoral fellowship is from the Mucosal immunology labs of National Institute of Immunology, New Delhi.

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