Effect of initial treatment on health-related quality of life in patients with newly diagnosed multiple myeloma without immediate stem cell transplant intent: results from the Connect® MM Registry

Abstract

Although new multiple myeloma (MM) therapies are effective in alleviating some disease-associated symptoms (e.g. bone pain, fatigue, functional decline), they can result in additional toxicities, further impacting health-related quality of life (HRQoL). Here, we compared HRQoL and safety of lenalidomide-bortezomib-dexamethasone [RVd (n = 445)], bortezomib-melphalan-prednisone [VMP (n = 77)] and Vd or VMP (n = 588) in patients with newly diagnosed MM (NDMM) from the Connect® MM Registry, a large, USA, multicentre, prospective observational cohort study. Functional Assessment of Cancer Therapy-Multiple Myeloma subscale, EuroQol-5D overall score and Bone Pain Inventory HRQoL scores were significantly improved with RVd versus Vd/VMP. Serious adverse event rates were similar in all groups. Treatment with RVd maintained HRQoL in this real-world, largely community-based population of patients with NDMM.

Keywords: health-related quality of life; lenalidomide; multiple myeloma; real-world evidence.

Conflict of interest statement

This study was funded by Celgene Corporation, and is currently supported by Bristol Myers Squibb. Rafat Abonour: member of steering committees for Celgene, a Bristol Myers Squibb Company and Takeda, research funding from Celgene, a Bristol Myers Squibb Company, Takeda and Prothena. Robert M. Rifkin: consultancy services to Amgen, Boehringer Ingelheim, Celgene, a Bristol Myers Squibb Company, EMD Serono, Sandoz and Takeda and owns stock with McKesson. Cristina Gasparetto: honoraria from Janssen, Bristol Myers Squibb, Celgene, a Bristol Myers Squibb Company and Takeda; provided consultancy services to Janssen, Bristol Myers Squibb and Celgene, a Bristol Myers Squibb Company; travel reimbursement from Janssen, Bristol Myers Squibb and Celgene, a Bristol Myers Squibb Company; and research funding from Celgene. Kathleen Toomey: consultancy services to Celgene, a Bristol Myers Squibb Company. Brian G. M. Durie: consultancy services to Takeda and Janssen. James W. Hardin: consultancy services to Celgene, a Bristol Myers Squibb Company. Howard R. Terebelo: consultancy services to Celgene, a Bristol Myers Squibb Company and participated in speakers’ bureaus for Janssen, Takeda and Pharmacyclics LLC, an AbbVie Company. Sundar Jagannath: consultancy services to Celgene, a Bristol Myers Squibb Company, Bristol Myers Squibb, Novartis and Merck and speakers’ bureaus for MMRF and Medicom. Mohit Narang: consultancy services and speakers’ bureaus for Celgene, a Bristol Myers Squibb Company and speakers’ bureaus for Janssen. Sikander Ailawadhi: consultancy services to Takeda, Novartis, Celgene, a Bristol Myers Squibb Company and Amgen, and research funding from Pharmacyclics, LLC, an AbbVie Company. James L. Omel: honoraria from Takeda Oncology and Celgene, a Bristol Myers Squibb Company, and on the board of directors/advisory committee for Takeda Oncology and Celgene, a Bristol Myers Squibb Company. Hans C. Lee: consultancy services for Adaptive Biotechnologies, Amgen, Celgene, a Bristol Myers Squibb Company, GlaxoSmithKline, Janssen, Sanofi and Takeda Pharmaceutical, and research funding from Amgen, Celgene, a Bristol Myers Squibb Company, Daiichi Sankyo, Eutropics Pharmaceuticals, GlaxoSmithKline, Janssen Pharmaceutical and Takeda Pharmaceutical. Shankar Srinivasan, Amani Kitali and Amit Agarwal: employed by Bristol Myers Squibb. Lynne Wagner: consultancy services to EveryFit, Gilead and Janssen.

© 2020 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.

Figures

Fig 1

Changes in health‐related quality of life (HRQoL) assessments during Q1–4 of initial treatment. BPI, Brief Pain Inventory; EQ‐5D, EuroQol‐5D; FACT‐MM, Functional Assessment of Cancer Therapy‐Multiple Myeloma; FACT‐MM TOI, FACT‐MM Trial Outcome Index; MCID, minimally important clinical difference; Q, quarter;. Legend text: MCIDs for HRQoL indices are 13·0‐point increase for FACT‐MM total, 11·0‐point increase for FACT‐MM TOI, 6·0‐point increase for FACT‐MM subscale, 0·1‐point increase for EQ‐5D overall score, and 1·5‐point decrease for BPI (lower values indicate improved HRQoL). *Results are based on mixed‐effect model, repeat measurement analysis adjusted by propensity score. Nominal P values are reported without adjustments for multiple testing.