Researchers presented updated health-related quality of life (HRQoL) data for patients with multiple myeloma (MM) which demonstrates that daratumumab plus lenalidomide and dexamethasone (D-Rd) provides superior sustained clinical benefits compared to lenalidomide and dexamethasone (Rd) therapy. The poster was presented at the 63rd ASH Annual Meeting & Exposition.

“The introduction of novel triplet regimens for newly diagnosed MM has extended progression-free survival (PFS) and overall survival (OS),” explained the researchers. “However, adverse events and demanding administration and monitoring schedules have a further negative effect on HRQoL, especially among patients who are transplant ineligible (TIE) due to older age and/or frailty.”

Because of these challenges, the researchers explained that optimizing first line therapy, particularly for older patients, is critical as some patients may only ever receive 1 line.

Researchers offered data from their updated HRQoL analysis with additional follow-up for patients participating in the randomized, open-label, active controlled, multicenter, phase 3 MAIA trial comprised of patients with newly diagnosed MM who were randomly assigned to receive D-Rd or Rd.

Patient-reported outcome (PRO) data was collected via the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item (EORTC QLQ-C30) and the EQ-5D-5L visual analog scale.

At 56.2 months (median follow-up), discontinuation rates were 56.8% and 80.8% for patients treated with D-Rd vs Rd, respectively. Additionally, patients initiating D-Rd therapy reported more meaningful improvement in physical functioning, fatigue, pain, and dyspnea.

At follow up, PRO data showed “the mean time to improvement was numerically shorter with D-Rd vs Rd for physical functioning and pain and with Rd vs D-Rd for [global health status] and fatigue.”

Other significant observations include:

• “median time to worsening of fatigue was similar between groups, numerically longer for D-Rd vs Rd for GHS, and significantly longer with D-Rd than Rd for physical functioning, pain, and dyspnea;
• Median time to worsening of pain with D-Rd vs Rd was 39.43 vs 17.97 months, reflective of an additional ~21 months without worsening pain among patients treated with D-Rd; and
• Between-group differences for least squares mean change from baseline for these 5 PROs favored D-Rd vs Rd at all assessment time points except cycle 3 for physical functioning and cycle 6 for fatigue; differences were significant at ≥1 timepoint for each scale.”

Overall, researchers concluded the updated PROs demonstrate sustained and clinically meaningful improvements with nearly 5 years of follow up.

Reference:
Perrot A, Facon T, Kumar SK, et al. Sustained improvement in health-related quality of life in transplant-ineligible patients with newly diagnosed multiple myeloma treated with daratumumab, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone: update of the phase 3 MAIA trial. Poster presented at: 63rd ASH Annual Meeting & Exposition; December 11-14, 2021; Atlanta, GA.