Quality of life gains in frail and intermediate-fit patients with multiple Myeloma: Findings from the prospective HOVON123 clinical trial
Frailty in newly-diagnosed multiple myeloma (NDMM) patients is associated with treatment-related toxicity, which negatively affects health-related quality of life (HRQoL). Currently, data on changes in HRQoL of frail and intermediate-fit MM patients during active treatment and post-treatment follow-...
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| Veröffentlicht in: | European journal of cancer (1990) 2024-08, Vol.207, p.114153, Article 114153 |
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| creator | Seefat, M.R. Stege, C.A.M. Lissenberg-Witte, B.I. Levin, M.D. Timmers, G.J. Hoogendoorn, M. Ypma, P.F. Klein, S.K. Velders, G.A. Westerman, M. Strobbe, L. Durdu-Rayman, N. Davidis-van Schoonhoven, M.A. van Kampen, R.J.W. Dijk, A.C. Koster, A. Silbermann, M.H. van der Spek, E. Beeker, A. Erjavec, Z. de Graauw, N.C.H.P. Leys, M.B.L. Sonneveld, P. van de Donk, N.W.C.J. Nasserinejad, K. Blommestein, H.M. Cucchi, D.G.J. Zweegman, S. |
| description | Frailty in newly-diagnosed multiple myeloma (NDMM) patients is associated with treatment-related toxicity, which negatively affects health-related quality of life (HRQoL). Currently, data on changes in HRQoL of frail and intermediate-fit MM patients during active treatment and post-treatment follow-up are absent.
The HOVON123 study (NTR4244) was a phase II trial in which NDMM patients ≥ 75 years were treated with nine dose-adjusted cycles of Melphalan-Prednisone-Bortezomib (MPV). Two HRQoL instruments (EORTC QLQ-C30 and -MY20) were obtained before start of treatment, after 3 and 9 months of treatment and 6 and 12 months after treatment for patients who did not yet start second-line treatment. HRQoL changes and/or differences in frail and intermediate-fit patients (IMWG frailty score) were reported only when both statistically significant (p MID).
137 frail and 71 intermediate-fit patients were included in the analysis. Compliance was high and comparable in both groups. At baseline, frail patients reported lower global health status, lower physical functioning scores and more fatigue and pain compared to intermediate-fit patients. Both groups improved in global health status and future perspective; polyneuropathy complaints worsened over time. Frail patients improved over time in physical functioning, fatigue and pain. Improvement in global health status occurred earlier than in intermediate-fit patients.
HRQoL improved during anti-myeloma treatment in both intermediate-fit and frail MM patients. In frail patients, improvement occurred faster and, in more domains, which was retained during follow-up. This implies that physicians should not withhold safe and effective therapies from frail patients in fear of HRQoL deterioration.
•HRQoL differs between intermediate-fit & frail patients before start of MM therapy.•HRQoL improves in both intermediate-fit & frail patients during initial MM therapy.•Frail patients show faster & larger improvements in HRQoL during first treatment.•Improvements in HRQoL persist during post-treatment follow-up.•Physicians should not refrain from treating frail patients in fear of HRQoL loss. |
| doi_str_mv | 10.1016/j.ejca.2024.114153 |
| format | Article |
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The HOVON123 study (NTR4244) was a phase II trial in which NDMM patients ≥ 75 years were treated with nine dose-adjusted cycles of Melphalan-Prednisone-Bortezomib (MPV). Two HRQoL instruments (EORTC QLQ-C30 and -MY20) were obtained before start of treatment, after 3 and 9 months of treatment and 6 and 12 months after treatment for patients who did not yet start second-line treatment. HRQoL changes and/or differences in frail and intermediate-fit patients (IMWG frailty score) were reported only when both statistically significant (p < 0.005) and clinically relevant (>MID).
137 frail and 71 intermediate-fit patients were included in the analysis. Compliance was high and comparable in both groups. At baseline, frail patients reported lower global health status, lower physical functioning scores and more fatigue and pain compared to intermediate-fit patients. Both groups improved in global health status and future perspective; polyneuropathy complaints worsened over time. Frail patients improved over time in physical functioning, fatigue and pain. Improvement in global health status occurred earlier than in intermediate-fit patients.
HRQoL improved during anti-myeloma treatment in both intermediate-fit and frail MM patients. In frail patients, improvement occurred faster and, in more domains, which was retained during follow-up. This implies that physicians should not withhold safe and effective therapies from frail patients in fear of HRQoL deterioration.
•HRQoL differs between intermediate-fit & frail patients before start of MM therapy.•HRQoL improves in both intermediate-fit & frail patients during initial MM therapy.•Frail patients show faster & larger improvements in HRQoL during first treatment.•Improvements in HRQoL persist during post-treatment follow-up.•Physicians should not refrain from treating frail patients in fear of HRQoL loss.</description><identifier>ISSN: 0959-8049</identifier><identifier>ISSN: 1879-0852</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2024.114153</identifier><identifier>PMID: 38870747</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Frailty score ; IMWG ; Multiple myeloma ; Newly diagnosed ; Quality of Life</subject><ispartof>European journal of cancer (1990), 2024-08, Vol.207, p.114153, Article 114153</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024. Published by Elsevier Ltd.</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c351t-139c46e915686277fb3c7775775bea7385c07666e3236e674bf0eec1ad665c773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0959804924008098$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38870747$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seefat, M.R.</creatorcontrib><creatorcontrib>Stege, C.A.M.</creatorcontrib><creatorcontrib>Lissenberg-Witte, B.I.</creatorcontrib><creatorcontrib>Levin, M.D.</creatorcontrib><creatorcontrib>Timmers, G.J.</creatorcontrib><creatorcontrib>Hoogendoorn, M.</creatorcontrib><creatorcontrib>Ypma, P.F.</creatorcontrib><creatorcontrib>Klein, S.K.</creatorcontrib><creatorcontrib>Velders, G.A.</creatorcontrib><creatorcontrib>Westerman, M.</creatorcontrib><creatorcontrib>Strobbe, L.</creatorcontrib><creatorcontrib>Durdu-Rayman, N.</creatorcontrib><creatorcontrib>Davidis-van Schoonhoven, M.A.</creatorcontrib><creatorcontrib>van Kampen, R.J.W.</creatorcontrib><creatorcontrib>Dijk, A.C.</creatorcontrib><creatorcontrib>Koster, A.</creatorcontrib><creatorcontrib>Silbermann, M.H.</creatorcontrib><creatorcontrib>van der Spek, E.</creatorcontrib><creatorcontrib>Beeker, A.</creatorcontrib><creatorcontrib>Erjavec, Z.</creatorcontrib><creatorcontrib>de Graauw, N.C.H.P.</creatorcontrib><creatorcontrib>Leys, M.B.L.</creatorcontrib><creatorcontrib>Sonneveld, P.</creatorcontrib><creatorcontrib>van de Donk, N.W.C.J.</creatorcontrib><creatorcontrib>Nasserinejad, K.</creatorcontrib><creatorcontrib>Blommestein, H.M.</creatorcontrib><creatorcontrib>Cucchi, D.G.J.</creatorcontrib><creatorcontrib>Zweegman, S.</creatorcontrib><title>Quality of life gains in frail and intermediate-fit patients with multiple Myeloma: Findings from the prospective HOVON123 clinical trial</title><title>European journal of cancer (1990)</title><addtitle>Eur J Cancer</addtitle><description>Frailty in newly-diagnosed multiple myeloma (NDMM) patients is associated with treatment-related toxicity, which negatively affects health-related quality of life (HRQoL). Currently, data on changes in HRQoL of frail and intermediate-fit MM patients during active treatment and post-treatment follow-up are absent.
The HOVON123 study (NTR4244) was a phase II trial in which NDMM patients ≥ 75 years were treated with nine dose-adjusted cycles of Melphalan-Prednisone-Bortezomib (MPV). Two HRQoL instruments (EORTC QLQ-C30 and -MY20) were obtained before start of treatment, after 3 and 9 months of treatment and 6 and 12 months after treatment for patients who did not yet start second-line treatment. HRQoL changes and/or differences in frail and intermediate-fit patients (IMWG frailty score) were reported only when both statistically significant (p < 0.005) and clinically relevant (>MID).
137 frail and 71 intermediate-fit patients were included in the analysis. Compliance was high and comparable in both groups. At baseline, frail patients reported lower global health status, lower physical functioning scores and more fatigue and pain compared to intermediate-fit patients. Both groups improved in global health status and future perspective; polyneuropathy complaints worsened over time. Frail patients improved over time in physical functioning, fatigue and pain. Improvement in global health status occurred earlier than in intermediate-fit patients.
HRQoL improved during anti-myeloma treatment in both intermediate-fit and frail MM patients. In frail patients, improvement occurred faster and, in more domains, which was retained during follow-up. This implies that physicians should not withhold safe and effective therapies from frail patients in fear of HRQoL deterioration.
•HRQoL differs between intermediate-fit & frail patients before start of MM therapy.•HRQoL improves in both intermediate-fit & frail patients during initial MM therapy.•Frail patients show faster & larger improvements in HRQoL during first treatment.•Improvements in HRQoL persist during post-treatment follow-up.•Physicians should not refrain from treating frail patients in fear of HRQoL loss.</description><subject>Frailty score</subject><subject>IMWG</subject><subject>Multiple myeloma</subject><subject>Newly diagnosed</subject><subject>Quality of Life</subject><issn>0959-8049</issn><issn>1879-0852</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kV1rFDEUhoNY7Lb6B7yQXHozazKZfIx4I8XaQu1SUG9DNnOmPUvmwyRT2Z_Qf22WrV4KgRB4zsvJ8xLylrM1Z1x92K1h5926ZnWz5rzhUrwgK250WzEj65dkxVrZVoY17Sk5S2nHGNOmYa_IqTBGM93oFXm6W1zAvKdTTwP2QO8djoniSPvoMFA3duWRIQ7QoctQ9Zjp7DLCmBP9jfmBDkvIOAeg3_YQpsF9pJc4djjep5IxDTQ_AJ3jlGbwGR-BXm1-bm55LagPOKJ3geaILrwmJ70LCd483-fkx-WX7xdX1c3m6_XF55vKC8lzxUXrGwUtl8qoWut-K7zWWpazBaeFkZ5ppRSIWihQutn2DMBz1yklCynOyftjbtnp1wIp2wGThxDcCNOSrGDKaFkrzQtaH1Ff1k8RejtHHFzcW87soQK7s4cK7KECe6ygDL17zl-2Rdq_kb_OC_DpCED55SNCtMkXnb4IjkWR7Sb8X_4fnheX3w</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Seefat, M.R.</creator><creator>Stege, C.A.M.</creator><creator>Lissenberg-Witte, B.I.</creator><creator>Levin, M.D.</creator><creator>Timmers, G.J.</creator><creator>Hoogendoorn, M.</creator><creator>Ypma, P.F.</creator><creator>Klein, S.K.</creator><creator>Velders, G.A.</creator><creator>Westerman, M.</creator><creator>Strobbe, L.</creator><creator>Durdu-Rayman, N.</creator><creator>Davidis-van Schoonhoven, M.A.</creator><creator>van Kampen, R.J.W.</creator><creator>Dijk, A.C.</creator><creator>Koster, A.</creator><creator>Silbermann, M.H.</creator><creator>van der Spek, E.</creator><creator>Beeker, A.</creator><creator>Erjavec, Z.</creator><creator>de Graauw, N.C.H.P.</creator><creator>Leys, M.B.L.</creator><creator>Sonneveld, P.</creator><creator>van de Donk, N.W.C.J.</creator><creator>Nasserinejad, K.</creator><creator>Blommestein, H.M.</creator><creator>Cucchi, D.G.J.</creator><creator>Zweegman, S.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240801</creationdate><title>Quality of life gains in frail and intermediate-fit patients with multiple Myeloma: Findings from the prospective HOVON123 clinical trial</title><author>Seefat, M.R. ; Stege, C.A.M. ; Lissenberg-Witte, B.I. ; Levin, M.D. ; Timmers, G.J. ; Hoogendoorn, M. ; Ypma, P.F. ; Klein, S.K. ; Velders, G.A. ; Westerman, M. ; Strobbe, L. ; Durdu-Rayman, N. ; Davidis-van Schoonhoven, M.A. ; van Kampen, R.J.W. ; Dijk, A.C. ; Koster, A. ; Silbermann, M.H. ; van der Spek, E. ; Beeker, A. ; Erjavec, Z. ; de Graauw, N.C.H.P. ; Leys, M.B.L. ; Sonneveld, P. ; van de Donk, N.W.C.J. ; Nasserinejad, K. ; Blommestein, H.M. ; Cucchi, D.G.J. ; Zweegman, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-139c46e915686277fb3c7775775bea7385c07666e3236e674bf0eec1ad665c773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Frailty score</topic><topic>IMWG</topic><topic>Multiple myeloma</topic><topic>Newly diagnosed</topic><topic>Quality of Life</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seefat, M.R.</creatorcontrib><creatorcontrib>Stege, C.A.M.</creatorcontrib><creatorcontrib>Lissenberg-Witte, B.I.</creatorcontrib><creatorcontrib>Levin, M.D.</creatorcontrib><creatorcontrib>Timmers, G.J.</creatorcontrib><creatorcontrib>Hoogendoorn, M.</creatorcontrib><creatorcontrib>Ypma, P.F.</creatorcontrib><creatorcontrib>Klein, S.K.</creatorcontrib><creatorcontrib>Velders, G.A.</creatorcontrib><creatorcontrib>Westerman, M.</creatorcontrib><creatorcontrib>Strobbe, L.</creatorcontrib><creatorcontrib>Durdu-Rayman, N.</creatorcontrib><creatorcontrib>Davidis-van Schoonhoven, M.A.</creatorcontrib><creatorcontrib>van Kampen, R.J.W.</creatorcontrib><creatorcontrib>Dijk, A.C.</creatorcontrib><creatorcontrib>Koster, A.</creatorcontrib><creatorcontrib>Silbermann, M.H.</creatorcontrib><creatorcontrib>van der Spek, E.</creatorcontrib><creatorcontrib>Beeker, A.</creatorcontrib><creatorcontrib>Erjavec, Z.</creatorcontrib><creatorcontrib>de Graauw, N.C.H.P.</creatorcontrib><creatorcontrib>Leys, M.B.L.</creatorcontrib><creatorcontrib>Sonneveld, P.</creatorcontrib><creatorcontrib>van de Donk, N.W.C.J.</creatorcontrib><creatorcontrib>Nasserinejad, K.</creatorcontrib><creatorcontrib>Blommestein, H.M.</creatorcontrib><creatorcontrib>Cucchi, D.G.J.</creatorcontrib><creatorcontrib>Zweegman, S.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cancer (1990)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seefat, M.R.</au><au>Stege, C.A.M.</au><au>Lissenberg-Witte, B.I.</au><au>Levin, M.D.</au><au>Timmers, G.J.</au><au>Hoogendoorn, M.</au><au>Ypma, P.F.</au><au>Klein, S.K.</au><au>Velders, G.A.</au><au>Westerman, M.</au><au>Strobbe, L.</au><au>Durdu-Rayman, N.</au><au>Davidis-van Schoonhoven, M.A.</au><au>van Kampen, R.J.W.</au><au>Dijk, A.C.</au><au>Koster, A.</au><au>Silbermann, M.H.</au><au>van der Spek, E.</au><au>Beeker, A.</au><au>Erjavec, Z.</au><au>de Graauw, N.C.H.P.</au><au>Leys, M.B.L.</au><au>Sonneveld, P.</au><au>van de Donk, N.W.C.J.</au><au>Nasserinejad, K.</au><au>Blommestein, H.M.</au><au>Cucchi, D.G.J.</au><au>Zweegman, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quality of life gains in frail and intermediate-fit patients with multiple Myeloma: Findings from the prospective HOVON123 clinical trial</atitle><jtitle>European journal of cancer (1990)</jtitle><addtitle>Eur J Cancer</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>207</volume><spage>114153</spage><pages>114153-</pages><artnum>114153</artnum><issn>0959-8049</issn><issn>1879-0852</issn><eissn>1879-0852</eissn><abstract>Frailty in newly-diagnosed multiple myeloma (NDMM) patients is associated with treatment-related toxicity, which negatively affects health-related quality of life (HRQoL). Currently, data on changes in HRQoL of frail and intermediate-fit MM patients during active treatment and post-treatment follow-up are absent.
The HOVON123 study (NTR4244) was a phase II trial in which NDMM patients ≥ 75 years were treated with nine dose-adjusted cycles of Melphalan-Prednisone-Bortezomib (MPV). Two HRQoL instruments (EORTC QLQ-C30 and -MY20) were obtained before start of treatment, after 3 and 9 months of treatment and 6 and 12 months after treatment for patients who did not yet start second-line treatment. HRQoL changes and/or differences in frail and intermediate-fit patients (IMWG frailty score) were reported only when both statistically significant (p < 0.005) and clinically relevant (>MID).
137 frail and 71 intermediate-fit patients were included in the analysis. Compliance was high and comparable in both groups. At baseline, frail patients reported lower global health status, lower physical functioning scores and more fatigue and pain compared to intermediate-fit patients. Both groups improved in global health status and future perspective; polyneuropathy complaints worsened over time. Frail patients improved over time in physical functioning, fatigue and pain. Improvement in global health status occurred earlier than in intermediate-fit patients.
HRQoL improved during anti-myeloma treatment in both intermediate-fit and frail MM patients. In frail patients, improvement occurred faster and, in more domains, which was retained during follow-up. This implies that physicians should not withhold safe and effective therapies from frail patients in fear of HRQoL deterioration.
•HRQoL differs between intermediate-fit & frail patients before start of MM therapy.•HRQoL improves in both intermediate-fit & frail patients during initial MM therapy.•Frail patients show faster & larger improvements in HRQoL during first treatment.•Improvements in HRQoL persist during post-treatment follow-up.•Physicians should not refrain from treating frail patients in fear of HRQoL loss.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38870747</pmid><doi>10.1016/j.ejca.2024.114153</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of cancer (1990), 2024-08, Vol.207, p.114153, Article 114153 |
| issn | 0959-8049 1879-0852 1879-0852 |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Frailty score IMWG Multiple myeloma Newly diagnosed Quality of Life |
| title | Quality of life gains in frail and intermediate-fit patients with multiple Myeloma: Findings from the prospective HOVON123 clinical trial |
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