P-118: Real-life data on patients with Multiple Myeloma (MM) and initiative to implement MM oncology navigation in the macro-region of Araçatuba-SP

Introduction:

Introduction: Multiple Myeoloma (MM), an incurable malignant neoplasm, accounts for approximately 10% of hematological neoplasms, and according to records from the World Health Organization (WHO) it was responsible for more than 170,000 new cases and 66% of deaths overall. The National Navigation Program for People Diagnosed with Cancer was incorporated with Law No. 14,785 of December 2023 of the National Cancer Policy, its purpose is to offer continuous care to cancer patients, as well as their caregivers and family members, which will from the onset of symptoms to the follow-up of treatment, aiming to overcome barriers in the diagnosis and treatment of the disease.

Methods:

Objectives: Real-life data from patients with MM being monitored at Unacon da Santa Casa de Araçatuba (SCA) and identification of barriers in diagnosis from primary to tertiary care for future implementation in an unprecedented way in Brazil within the macro-region of Araçatuba-SP.

Methods: The epidemiological profile, disease characteristics and treatment data were analyzed in 34 patients with MM followed in 2024 (January to April) within the SCA Unacon. The NICE (United Kingdom health system) cancer diagnosis and monitoring alarm system was adapted to the Brazilian reality of the Araçatuba-SP macro-region to begin the implementation of oncology navigation.

Results:

Results: Of the total of 34 patients, there was a slight predominance of males (53 vs. 47%) and a median age of 69.5 years. The ISS was divided into I of 23.53%, II of 17.65%, III of 32.35% and undefined of 26.4% with 11.8% of extramedullary disease at diagnosis. Based on the APAC procedure code there were 67.6% of patients on 1L chemotherapy, 20.5% on 2L or more and 11.9% on palliative care with 11.76% receiving autologous consolidative HSCT. The most used induction protocol was CyBord and only one patient was on lenalidomide maintenance. In an attempt to reduce barriers to rapid diagnosis and treatment, we identified as a possible “red flag”, the use of serum protein electrophoresis (SPE) in all patients in primary and/or secondary care who present non-deficiency anemia, a disease progressive and/or unexplained renal failure and persistent bone pain with or without suggestive radiological imaging.

Conclusions:

Conclusion: Real-life data from MM in the macro-region of Araçatuba-SP confirm those from GBRAM, especially in the SUS scenario, with advanced disease at diagnosis, very low percentage of consolidation HSCT and restricted access to effective treatments. Initial approach with SPE in suspected cases, followed by the implementation of oncology navigation in MM, using all SUS equipment; teaching/assistance partnership; regulation will bring a new reality to the care of patients with MM in the macro-region of Araçatuba-SP.