Vogl Dan T, Delforge Michel, Song Kevin, Guo Shien, Gibson Craig J, Ervin-Haynes Annette, Facon Thierry
a Abramson Cancer Center, University of Pennsylvania , Philadelphia , PA , USA.
b Campus Gasthuisberg, Universitair Ziekenhuis Leuven , Leuven , Belgium.
Leuk Lymphoma. 2018 Feb;59(2):398-405. doi: 10.1080/10428194.2017.1334125. Epub 2017 Jun 22.
The FIRST trial demonstrated that continuous therapy with lenalidomide and dexamethasone (Rd) prolongs overall survival (OS) and improves health-related quality of life (HRQoL) during the first 18 months of therapy in newly diagnosed multiple myeloma (NDMM) patients. However, patient-reported HRQoL data were not collected after 18 months. We therefore estimated HRQoL scores based on time-varying data collected during progression-free follow-up after 18 months. During the initial 18 months of Rd, observed changes from baseline were within the 95% confidence interval of the predictive models at 33 of 35 time points across 7 HRQoL scores. Predicted scores after 18 months of therapy showed that observed HRQoL improvements during therapy were maintained or improved. Therefore, the survival gain observed with Rd does not come at a cost of declining HRQoL during continuous therapy beyond 18 months, supporting long-term Rd as a standard of care for initial myeloma therapy.
第一项试验表明，来那度胺和地塞米松持续治疗（Rd）可延长新诊断的多发性骨髓瘤（NDMM）患者治疗的前18个月的总生存期（OS），并改善健康相关生活质量（HRQoL）。然而，18个月后未收集患者报告的HRQoL数据。因此，我们根据18个月后无进展随访期间收集的随时间变化的数据估算了HRQoL评分。在Rd治疗的最初18个月期间，在7个HRQoL评分的35个时间点中的33个时间点，观察到的相对于基线的变化处于预测模型的95%置信区间内。治疗18个月后的预测评分显示，治疗期间观察到的HRQoL改善得以维持或提高。因此，Rd治疗带来的生存获益并不会以超过18个月的持续治疗期间HRQoL下降为代价，这支持将长期Rd作为初始骨髓瘤治疗的护理标准。
