Long-term health-related quality of life in transplant-ineligible patients with newly diagnosed multiple myeloma receiving lenalidomide and dexamethasone

Vogl, Dan T.; Delforge, Michel; Song, Kevin; Guo, Shien; Gibson, Craig J.; Ervin-Haynes, Annette; Façon, Thierry

doi:10.1080/10428194.2017.1334125

Cited by 10 publications

(7 citation statements)

References 28 publications

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“…Limited QoL data have been reported from studies of long-term treatment approaches; however, the available findings appear promising, suggesting that such therapies do not typically have an adverse impact on QoL (Table 7) 28,49,58,64,[92][93][94][95] . However, commonly used QoL instruments may not capture all aspects of importance to patients receiving long-term therapy, e.g.…”

Section: Safety and Tolerability Of Long-term Treatment Approachesmentioning

confidence: 99%

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

et al. 2020

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The evolving paradigm of continuous therapy and maintenance treatment approaches in multiple myeloma (MM) offers prolonged disease control and improved outcomes compared to traditional fixed-duration approaches. Potential benefits of long-term strategies include sustained control of disease symptoms, as well as continued cytoreduction and clonal control, leading to unmeasurable residual disease and the possibility of transforming MM into a chronic or functionally curable condition. "Continuous therapy" commonly refers to administering a doublet or triplet regimen until disease progression, whereas maintenance approaches typically involve single-agent or doublet treatment following more intensive prior therapy with autologous stem cell transplant (ASCT) or doublet, triplet, or even quadruplet induction therapy. However, the requirements for agents and regimens within these contexts are similar: treatments must be tolerable for a prolonged period of time, should not be associated with cumulative or chronic toxicity, should not adversely affect patients' quality of life, should ideally be convenient with a minimal treatment burden for patients, and should not impact the feasibility or efficacy of subsequent treatment at relapse. Multiple agents have been and are being investigated as long-term options in the treatment of newly diagnosed MM (NDMM), including the immunomodulatory drugs lenalidomide and thalidomide, the proteasome inhibitors bortezomib, carfilzomib, and ixazomib, and the monoclonal antibodies daratumumab, elotuzumab, and isatuximab. Here we review the latest results with long-term therapy approaches in three different settings in NDMM: (1) maintenance treatment post ASCT; (2) continuous frontline therapy in nontransplant patients; (3) maintenance treatment post-frontline therapy in the nontransplant setting. We also discuss evidence from key phase 3 trials. Our review demonstrates how the paradigm of long-term treatment is increasingly well-established across NDMM treatment settings, potentially resulting in further improvements in patient outcomes, and highlights key clinical issues that will need to be addressed in order to provide optimal benefit.

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Section: Safety and Tolerability Of Long-term Treatment Approachesmentioning

confidence: 99%

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

et al. 2020

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“…Despite this, patients continue to relapse and survival after exposure to the three main classes of drugs [proteasome inhibitors (PIs), immunomodulatory drugs, and anti‐cluster of differentiation 38 (CD38) monoclonal antibodies (mAbs)] results in triple‐class–exposed or –refractory disease, with suboptimal outcomes 1–3 . Moreover, this improvement in survival has contributed to an increased proportion of patients with relapsed/refractory MM (RRMM) living with the burden of symptoms and complications associated with the disease and prior lines of therapy 3,4 . RRMM is associated with severe symptoms, of which pain, fatigue, physical functioning, and emotional functioning have been strongly linked to impairments in health‐related quality of life (HRQoL) of patients 5,6 .…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Moreover, this improvement in survival has contributed to an increased proportion of patients with relapsed/refractory MM (RRMM) living with the burden of symptoms and complications associated with the disease and prior lines of therapy. 3,4 RRMM is associated with severe symptoms, of which pain, fatigue, physical functioning, and emotional functioning have been strongly linked to impairments in health-related quality of life (HRQoL) of patients. 5,6 Treatment goals for late-stage patients with RRMM should therefore not only include extending survival but also managing disease and treatment-related symptoms and preserving, or potentially improving, HRQoL.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Treatment goals for late-stage patients with RRMM should therefore not only include extending survival but also managing disease and treatment-related symptoms and preserving, or potentially improving, HRQoL. 4,7 Melphalan flufenamide (melflufen) is a first-in-class peptide-drug conjugate (PDC) that targets aminopeptidases and thereby rapidly releases alkylating agents inside tumour cells, and has been approved by the United States Food and Drug Administration (FDA) for use in patients with RRMM. [8][9][10][11][12][13] In the pivotal, Phase II, HORIZON study (OP-106; ClinicalTrials.gov identifier: NCT02963493), melflufen plus dexamethasone showed clinically meaningful efficacy with an overall response rate (ORR) of 29%, median progression-free survival of 4Á2 months, median overall survival of 11Á6 months, and a manageable safety profile in patients with advanced RRMM.…”

Section: Introductionmentioning

confidence: 99%

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Patient‐reported outcomes in relapsed/refractory multiple myeloma treated with melflufen plus dexamethasone: analyses from the Phase II HORIZON study

et al. 2021

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Relapsed/refractory multiple myeloma (RRMM) is known to have a high burden of disease and complications associated with refractoriness to prior lines of therapy. Severe pain and fatigue symptoms and impairments in physical and emotional functioning have been strongly linked to reduced health-related quality of life (HRQoL) in patients with RRMM. Assessment of patient reported-outcome measures from the pivotal, Phase II HORI-ZON study (OP-106; NCT02963493) in patients with RRMM (n = 64) demonstrated that melphalan flufenamide (melflufen) plus dexamethasone treatment preserved HRQoL. Patients had clinically meaningful improvements, even after eight treatment cycles, in relevant scales such as global health status/QoL, physical functioning, emotional functioning, pain, and fatigue. Patients with triple-class-refractory disease (n = 50) displayed similar improvements. Patient-reported outcome deterioration was delayed for a substantial amount of time in patients who experienced a response to melflufen plus dexamethasone treatment relative to patients who did not experience a response. These findings support the notion that treatment with melflufen plus dexamethasone may sustain or improve HRQoL over time in patients with RRMM, including in patients with triple-class-refractory disease for whom outcomes are generally worse. The clinical benefits observed in patients from the HORIZON trial are encouraging and supportive of translation into real-world practice.

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“…This can be due to mental and psychological problems during disease diagnosis period and the shock induced by being informed of the disease [29], [30], [31], [32], [33].…”

Section: Discussionmentioning

confidence: 99%

Anxiety and Depression in Patients with Breast Cancer: A Cross-sectional Study

Podvorica

Kraja

Rrustemi

et al. 2022

Open Access Maced J Med Sci

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BACKROUND: The early management for distress, depression, and anxiety in breast cancer patients can help improves quality of life that adherence patients to cancer treatment. AIM: This study aimed to describe the prevalence and risk factors of anxiety and depression symptomatology of breast cancer patients in the inpatients and outpatient settings. METHODS: This study used a research and development study design. The study was conducted in at the University Clinical Center of Kosovo the Medical Oncology Clinic in Pristina from August to October 2021. The total sample in this study consisted of 50 female breast cancer patients diagnosed at least 6 months before the date of assessment, aged 18 and above, able to communicate in Albanian, signed an informed consent form, negative history of other malignancies, and absence of any temporary acute illness affecting psychological well-being while filling the questionnaire. Questionnaire used in our study is Hospital Anxiety and Depression Scale for assessing anxiety and depression in breast cancer patients. RESULTS: For anxiety score, some of them were caseness level with 82%, while 26% of study participants were in borderline, 6% in caseness, and some of them were in normal level from 68% on the depression score. The patients feel tense or wound up with 44% Mean/SD (14.67 ± 6.02), about feeling afraid that something terrible will happen and patients may have this feel Mean/SD (13 ± 1.66). Over half of them had the feeling of fear as if something awful is about to happen Mean/SD (11.33 ± 4.03) and that the feeling of fear as if they had “butterflies” in the stomach of 62% had the feeling sometimes, beautiful often, and very often Mean/SD (10.33 ± 4.92). CONCLUSION: The results indicate that it is very important to measure the level of anxiety and depression in women with breast cancer, which are two common mental disorders in breast cancer.

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Long-term health-related quality of life in transplant-ineligible patients with newly diagnosed multiple myeloma receiving lenalidomide and dexamethasone

Cited by 10 publications

References 28 publications

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

Patient‐reported outcomes in relapsed/refractory multiple myeloma treated with melflufen plus dexamethasone: analyses from the Phase II HORIZON study

Anxiety and Depression in Patients with Breast Cancer: A Cross-sectional Study

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