PCN305 Systematic Literature Review (SLR) of Evidence on the Humanistic Burden of Relapsed/Refractory Multiple Myeloma (RRMM)

Abstract

Multiple myeloma is an incurable B-cell malignancy where patients cycle through periods of remission and relapse. Novel therapies have improved survival in RRMM in the last 5 years. The objective was to conduct a comprehensive review of published evidence on the humanistic burden in RRMM. A systematic literature review (SLR) was conducted following the Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using Population, Intervention & Comparators, Outcomes and Study Design (PICOS) criteria to identify relevant health-related quality of life (HRQoL) studies published between 2014 and 2019 in biomedical databases (EMBASE, MEDLINE, Cochrane) and congresses. A total of 2,591 records were screened using the PICOS-based criteria. Seventy-three HRQoL studies were included (24 interventional, nine observational, 23 cross-sectional surveys, three SLRs, 13 economic studies, one PRO validation). Patients with RRMM experienced a high symptom burden and poor HRQoL. Across six symptom survey studies, fatigue, pain, breathlessness, and neuropathy were the most commonly reported symptoms, with pain and fatigue regarded as being most debilitating. HRQoL, most frequently measured by the EORTC QLQ-C30, declined with disease progression. HRQoL improvements, also typically measured by the EORTC QLQ-C30, were not observed in interventional studies; however, in ten randomized controlled trials, HRQoL was maintained following the addition of a third agent to doublet standard of care (SOC). Use of newer agents in later treatment lines (4L+) was associated with maintenance of HRQoL versus SOC alone in three studies. Results of observational studies also showed that despite treatments, patients experience a high burden of symptoms, and HRQoL deteriorates with disease progression. This SLR demonstrated substantial humanistic burden in RRMM. Although maintenance of HRQoL was possible with treatment, improvement was not demonstrated, indicating the need for additional treatments options that can provide both efficacy and HRQoL benefits to patients with RRMM.