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达雷妥尤单抗、硼替佐米、美法仑和泼尼松联合用药与单独使用硼替佐米、美法仑和泼尼松治疗新诊断的不适于移植的多发性骨髓瘤患者的健康相关生活质量:3期OCTANS研究分析

Health-related quality of life with daratumumab, bortezomib, melphalan, and prednisone versus bortezomib, melphalan, and prednisone alone in transplant-ineligible patients with newly diagnosed multiple myeloma: analysis of the phase 3 OCTANS study.

作者信息

Fu Weijun, Bang Soo-Mee, Huang Honghui, Kim Kihyun, Li Wei, An Gang, Lee Je-Jung, Cai Zhen, Jin Jie, Wang Yafei, Chim Chor Sang, Carson Robin, Liu Rui, Zhao Man, Chen Xi, Cui Canchan, Hou Jian, Wang Jianxiang

机构信息

Shanghai Changzheng Hospital, Shanghai, China.

Seoul National University Bundang Hospital, Seongnam, South Korea.

出版信息

Ann Hematol. 2025 May 23. doi: 10.1007/s00277-025-06303-3.

Abstract

In the phase 3 OCTANS study, daratumumab plus bortezomib/melphalan/prednisone (D-VMP) significantly improved response rates and progression-free survival versus VMP alone in transplant-ineligible Asian patients with newly diagnosed multiple myeloma (NDMM). Understanding the impact of treatment on patient-reported outcomes (PROs) is of increasing interest. Here, we report on the impact of D-VMP and VMP on PROs in OCTANS. PROs were a secondary endpoint and were assessed using the 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) questionnaire, administered at screening, every 3 months (Year 1), every 6 months thereafter (until disease progression), and 8 and 16 weeks post disease progression. Treatment effects were estimated using a mixed-effects model with repeated measures. Overall, 220 patients were randomized (D-VMP, n = 146; VMP, n = 74). Compliance rates were 100% at baseline in both treatment groups and remained relatively high by Month 12 (D-VMP, 82.6%; VMP, 67.4%). Comparable improvements from baseline were generally observed between treatment groups across most PRO scores. Significant improvements were observed with D-VMP versus VMP in Global Health Status (GHS) score at 9 months (p = 0.0443) and in social functioning and nausea and vomiting symptom scores at 12 months (p = 0.0042 and p = 0.0012, respectively). In summary, transplant-ineligible Asian patients with NDMM demonstrated improvements in PROs following treatment with D-VMP and VMP; however, greater improvements were observed in GHS, social functioning, and nausea and vomiting symptoms with D-VMP.

摘要

在3期OCTANS研究中,与单独使用硼替佐米/美法仑/泼尼松(VMP)相比,达雷妥尤单抗联合硼替佐米/美法仑/泼尼松(D-VMP)显著提高了新诊断的多发性骨髓瘤(NDMM)且不符合移植条件的亚洲患者的缓解率和无进展生存期。了解治疗对患者报告结局(PRO)的影响越来越受到关注。在此,我们报告了D-VMP和VMP对OCTANS研究中PRO的影响。PRO是次要终点,使用欧洲癌症研究与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描述系统(EQ-5D-5L)问卷进行评估,在筛查时、第1年每3个月、此后每6个月(直至疾病进展)以及疾病进展后8周和16周进行。使用重复测量的混合效应模型估计治疗效果。总体而言,220例患者被随机分组(D-VMP组,n = 146;VMP组,n = 74)。两个治疗组在基线时的依从率均为100%,到第12个月时仍相对较高(D-VMP组为82.6%;VMP组为67.4%)。在大多数PRO评分中,两个治疗组从基线开始的改善情况总体相当。在第9个月时,D-VMP组与VMP组相比,全球健康状况(GHS)评分有显著改善(p = 0.0443);在第12个月时,社交功能以及恶心和呕吐症状评分也有显著改善(分别为p = 0.0042和p = 0.0012)。总之,不符合移植条件的亚洲NDMM患者在接受D-VMP和VMP治疗后PRO有所改善;然而,D-VMP在GHS、社交功能以及恶心和呕吐症状方面的改善更为明显。

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