Among patients with newly diagnosed, transplant-ineligible multiple myeloma (MM), the combination of daratumumab, lenalidomide, and dexamethasone (D-Rd) appears to yield improved patient-reported outcomes compared with lenalidomide and dexamethasone (Rd) alone, according to research published in the Journal of Clinical Oncology.

Despite improvements in treatment and survival over the past several decades, reduced health-related quality of life (HRQOL) remains a significant issue among patients with MM, particularly among those who are transplant-ineligible. Daratumumab, an anti-CD38 monoclonal antibody, was shown to significantly improve outcomes in MM; however, its effect on HRQOL, as measured by patient-reported outcomes, was previously unestablished.

Using the results from the phase 3 MAIA trial (ClinialTrials.gov Identifier: NCT02252172), a team of researchers compared the HRQOL outcomes of patients with newly diagnosed MM who were treated with D-Rd vs Rd. These effects were determined through evaluation of patient-reported outcomes, which included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item test and the EuroQol 5-dimensional descriptive system. Patient-reported outcomes were included at baseline and again every 3 months throughout treatment.


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In the D-Rd (368 patients; 48.6% women) and Rd (369 patients; 47.2% women) groups, 208 patients in each group were younger than 75 years. An Eastern Cooperative Oncology Group Performance Status of 2 was reported in 63 patients (17.1%) in the D-Rd cohort and 59 patients (16%) in the Rd cohort. Patient compliance with patient-reported outcome assessment was greater than 90% at baseline and greater than 78% through month 12.

In both groups, patient-reported outcome measures improved from baseline, though patients in the D-Rd group had consistently better HRQOL, as according to scores on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item test. Health status improved in both groups regardless of age or performance status, though patients in the D-Rd group had improved pain reduction compared with patients in the Rd group (P =.0007).

“As the treatment landscape evolves for patients with [newly diagnosed] MM, the goals of first-line therapy should include improvement or maintenance of HRQOL reflecting clinical efficacy. Addition of daratumumab to [standard of care] regimens supports these treatment goals in [transplant-ineligible] patients,” the authors wrote.

Disclosure: Some authors have declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.

Reference

Perrot A, Facon T, Plesner T, et al. Health-related quality of life in transplant-ineligible patients with newly diagnosed multiple myeloma: findings from the phase III MAIA trial. J Clin Oncol. Published online December 16, 2020. doi:10.1200/JCO.20.01370