Quality of life in patients with relapsed/refractory multiple myeloma during ixazomib-thalidomide-dexamethasone induction and ixazomib maintenance therapy and comparison to the general population

Abstract

This trial evaluated quality of life (QoL) using the EORTC QLQ-C30 and the EORTC QLQ-MY20 instruments in 90 patients with relapsed/refractory multiple myeloma during induction and maintenance therapy with eight cycles of ixazomib-thalidomide-dexamethasone, followed by 12 months of ixazomib maintenance therapy. When patient’s baseline QoL was compared with data of the general population, a significant impairment in health-related QoL, physical, role, and social functioning and several other dimensions, as well as more pain and fatigue, was noted. Induction therapy resulted in significant improvement of pain and worsening of neuropathy, with no significant variation of other parameters. During maintenance treatment, scores for most dimensions including health-related QoL, physical functioning and pain, improved, while for neuropathy no improvement was observed. Time to deterioration (≥10 score points) of health-related QoL, physical functioning, pain, and neuropathy was distinctly shorter than time to progression. Health-related QoL and physical functioning at baseline correlated with overall survival.

Keywords:

• Multiple myeloma
• quality of life
• ixazomib
• thalidomide
• relapsed/refractory disease

Acknowledgments

The authors thank Dr. Daniela Wolkersdorfer for her support in conducting the trial within the AGMT (Arbeitsgemeinschaft Medikamentöse Tumortherapie).

Author contributions

H. L., W. P., S. T. K., A. E., M. S., D. L., R. H., E. G., A. P., K. W., D. N., H. E., W. W., H. R., L. P., T. J., K. K., T. M., R. G., and N. Z. treated patients within the study, S. N. provided Clinical Lymphoma, Myeloma & Leukemia January 2019 data from individuals of the general population; A. H. provided statistical expertise. A. M. analyzed data. H. L. wrote a first draft of the manuscript. All authors participated in the manuscript development and approved the final version.

Disclosure statement

H. L. received research funding from Takeda, Amgen; Speaker’s Bureau from Takeda, Amgen, Janssen, BMS, Celgene; and consultancy fees from PharmaMar. S. K. received consultancy fees from Takeda. A. H. received Honoraria from Roche. E. G. received Honoraria from Takeda, Janssen, Amgen, BMS and Advisory Board from Takeda, Janssen, Amgen, Novartis. A. P. received Honoraria and Advisory Board from Takeda, Celgene. K. W. received Honoraria from Novartis, Janssen, Celgene, Amgen, Onyx, Takeda, BMS and consultancy fees from Janssen, Celgene, Amgen, BMS, Takeda, Onyx. H. E. received Speaker’s Bureau, Advisory Board from Celgene, Janssen, Amgen, BMS, Novartis and consultancy fees, Honoraria from Celgene, Janssen, BMS, Amgen. W. W. received research funding from Amgen, BMS, Celgene, Janssen, Novartis, Roche, Takeda and Advisory Board/Consultancy fees from Amgen, BMS, Celgene, Janssen, Novartis, Pfizer, Roche, Sandoz, Takeda. TM received Honoraria from Takeda. NZ received honoraria from Takeda, Celgene, Janssen, Amgen. The remaining authors declare no competing financial interests.

Additional information

Funding

The study was supported by a research grant from Takeda.