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在复发或难治性多发性骨髓瘤患者中的健康相关生活质量:在 3 期 POLLUX 试验中用达雷妥尤单抗、来那度胺和地塞米松治疗。

Health-related quality of life in patients with relapsed or refractory multiple myeloma: treatment with daratumumab, lenalidomide, and dexamethasone in the phase 3 POLLUX trial.

机构信息

Vejle Hospital and University of Southern Denmark, Vejle, Denmark.

National and Kapodistrian University of Athens School of Medicine, Athens, Greece.

出版信息

Br J Haematol. 2021 Jul;194(1):132-139. doi: 10.1111/bjh.17435. Epub 2021 Apr 6.

Abstract

In the phase 3 POLLUX trial, daratumumab in combination with lenalidomide and dexamethasone (D-Rd) significantly improved progression-free survival in patients with relapsed/refractory multiple myeloma (RRMM) compared with lenalidomide and dexamethasone (Rd) alone. Here, we present patient-reported outcomes (PROs) from POLLUX, assessed using the validated European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item (EORTC QLQ-C30) and the EuroQol 5-dimensional descriptive system (EQ-5D-5L) questionnaires. Changes from baseline are presented as least-squares mean changes with 95% confidence intervals (CIs) derived from a mixed-effects model. PRO assessment compliance rates were high and similar in both D-Rd and Rd groups through cycle 40 (week 156). In this on-treatment analysis, mean changes from baseline were significantly greater in EORTC QLQ-C30 global health status, physical functioning, and pain scores in the D-Rd group versus the Rd group at multiple time points; however, magnitude of changes was low, suggesting no meaningful impact on health-related quality of life (HRQoL). Subgroup results were similar to those in the overall population. In the POLLUX study, baseline HRQoL was maintained with prolonged D-Rd treatment. These findings complement the sustained and significant improvement in progression-free survival observed with D-Rd and supports its use in patients with RRMM. Clinical trial registration: NCT02076009.

摘要

在 POLLUX 三期临床试验中,与来那度胺和地塞米松(Rd)单独治疗相比,达雷妥尤单抗联合来那度胺和地塞米松(D-Rd)可显著改善复发/难治性多发性骨髓瘤(RRMM)患者的无进展生存期。在此,我们展示了 POLLUX 研究的患者报告结局(PRO)数据,使用经过验证的欧洲癌症研究和治疗组织生活质量问卷核心 30 项(EORTC QLQ-C30)和欧洲五维健康量表(EQ-5D-5L)问卷进行评估。采用混合效应模型,从基线变化呈现最小二乘均数变化及其 95%置信区间(CI)。PRO 评估的依从率在 D-Rd 组和 Rd 组均较高,且在第 40 周期(第 156 周)时保持一致。在这项治疗中分析中,在多个时间点,D-Rd 组与 Rd 组相比,EORTC QLQ-C30 整体健康状况、身体功能和疼痛评分的基线变化均值均显著更大;然而,变化幅度较小,提示对健康相关生活质量(HRQoL)没有明显影响。亚组结果与总体人群结果相似。在 POLLUX 研究中,D-Rd 的延长治疗维持了基线 HRQoL。这些发现补充了 D-Rd 观察到的无进展生存期的持续显著改善,并支持其在 RRMM 患者中的应用。临床试验注册:NCT02076009。

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