Abstract
BackgroundCarfilzomib and daratumumab are licensed in relapsed/refractory multiple myeloma (RRMM), but no head-to-head trials have been conducted.MethodsWe used data from dossiers prepared for the German Federal Joint Committee based on two phase III randomized trials of carfilzomib-based therapies (ASPIRE, ENDEAVOR) and two of daratumumab-based therapies (POLLUX, CASTOR) to conduct a descriptive assessment of health-related quality of life (HRQoL). HRQoL was assessed using the European Organisation for Research and Treatment of Cancer 30-item HRQoL Questionnaire, with hazard ratios calculated for carfilzomib- and daratumumab-based therapy versus comparators for time to HRQoL deterioration of ≥ 10 points. Analyses were also conducted on data from the EORTC 20-item myeloma-specific questionnaire, the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity scale, and the visual analog scale of the EuroQoL 5-dimension, 5-level questionnaire, where results for these instruments were available. As the designs and patient population of the four trials were similar but not identical, the analysis included only indirect, descriptive comparisons.ResultsCompared with lenalidomide/dexamethasone, median time to deterioration in global health status/QoL was longer for carfilzomib-based therapy versus control, but similar for daratumumab-based therapy and control. Compared with bortezomib/dexamethasone, time to deterioration was significantly longer for carfilzomib-based therapy versus control for global health status/QoL and numerous functional and symptom subscales. HRQoL measurement is feasible in large RRMM populations.ConclusionDescriptive assessment of HRQoL data suggests potential benefits for carfilzomib-based over daratumumab-based therapy.
Highlights
Multiple myeloma (MM) is an incurable, relapsing disease that is generally diagnosed in elderly individuals; median age at diagnosis is 72 years for men and 74 years for women [1,2,3]
Patients enrolled in the ASPIRE and ENDEAVOR studies had EORTC QLQ-C30 global health status/quality of life (QoL) scores of ~ 50–60 of a maximum of 100 [24, 35, 36]
health-related quality of life (HRQoL) deteriorations were observed across all four phase III RRMM trials included here, indirect, descriptive comparison across these trials suggests that the risk of HRQoL deterioration is less with carfilzomib-based than with daratumumabbased therapy
Summary
Multiple myeloma (MM) is an incurable, relapsing disease that is generally diagnosed in elderly individuals; median age at diagnosis is 72 years for men and 74 years for women [1,2,3]. Methods We used data from dossiers prepared for the German Federal Joint Committee based on two phase III randomized trials of carfilzomib-based therapies (ASPIRE, ENDEAVOR) and two of daratumumab-based therapies (POLLUX, CASTOR) to conduct a descriptive assessment of health-related quality of life (HRQoL). HRQoL was assessed using the European Organisation for Research and Treatment of Cancer 30-item HRQoL Questionnaire, with hazard ratios calculated for carfilzomib- and daratumumab-based therapy versus comparators for time to HRQoL deterioration of ≥ 10 points. Results Compared with lenalidomide/dexamethasone, median time to deterioration in global health status/QoL was longer for carfilzomib-based therapy versus control, but similar for daratumumab-based therapy and control. Compared with bortezomib/dexamethasone, time to deterioration was significantly longer for carfilzomib-based therapy versus control for global health status/QoL and numerous functional and symptom subscales. Conclusion Descriptive assessment of HRQoL data suggests potential benefits for carfilzomib-based over daratumumabbased therapy
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