Real-World Evaluation of Health-Related Quality of Life in Patients With Multiple Myeloma From Germany

Clin Lymphoma Myeloma Leuk. 2021 Feb;21(2):e160-e175. doi: 10.1016/j.clml.2020.10.002. Epub 2020 Oct 24.

Abstract

Introduction: Real-world health-related quality of life (HRQoL) data in patients with multiple myeloma (MM) are scarce. Here, we report HRQoL by line of therapy in adults with MM in clinical practice in Germany.

Patients and methods: This descriptive, multicenter, observational study included patients receiving all lines of MM therapy or best supportive care (BSC). The primary endpoint was HRQoL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 global health status [GHS]) by line of therapy; secondary endpoints included patient/disease characteristics and treatments by line of therapy.

Results: Overall, 490 patients were included from 40 centers (mean age 71.0 years, 62% male); 59% had an Eastern Cooperative Oncology Group performance status of 0 or 1% and 35% had undergone stem cell transplantation. First-line therapy included proteasome inhibitors in 81% of patients; subsequent treatments varied. The mean overall GHS/QoL score was 49.5; HRQoL decreased by therapy line (P < .001) and was lowest in those receiving BSC. Functional and symptoms scores worsened with increasing treatment line. The largest HRQoL reduction occurred when patients switched from active treatment to BSC. Compared with those on active treatment, patients in a treatment-free interval generally had better GHS/QoL, functioning, and fewer symptoms (P < .05). GHS/QoL also generally improved and symptoms lessened in those with ≥1 versus <1 year of ongoing treatment (P < .05). Worse GHS/QoL was observed in patients with ≥1 grade 3/4 toxicity versus those with none (P = .012). Eastern Cooperative Oncology Group performance status was the strongest determinant of HRQoL.

Conclusions: This real-world study shows that patients with MM have impaired HRQoL and that HRQoL deteriorates with increasing lines of therapy.

Trial registration: ClinicalTrials.gov NCT03308474 NCT02892383 NCT01081028 NCT02946333 NCT02970747 NCT03344328.

Keywords: ECOG performance status; EORTC QLQ-C30 Global Health Status; EORTC QLQ-MY20; Line of therapy; Real-world data.

Publication types

  • Research Support, Non-U.S. Gov't

Associated data

  • ClinicalTrials.gov/NCT03308474
  • ClinicalTrials.gov/NCT02892383
  • ClinicalTrials.gov/NCT01081028
  • ClinicalTrials.gov/NCT02946333
  • ClinicalTrials.gov/NCT02970747
  • ClinicalTrials.gov/NCT03344328