Evaluating the health-related quality of life in patients with multiple myeloma treated with daratumumab combined with bortezomib and dexamethasone.

This study investigated the health-related quality of life (HRQoL) for patients with relapsed/refractory (RR) multiple myeloma (MM) patients treated with D-Vd (daratumumab, bortezomib, and dexamethasone) compared to Vd (bortezomid and dexamethasone). The study showed that HRQoL did not decrease for 8 therapy cycles and long-term improvements were seen in daratumumab-treated patients.

Multiple myeloma (MM) is an incurable blood cancer that has negative effects on the HRQoL.

Daratumumab (Darzalex) is an immunotherapy that can be used on its own or in combination with other novel agents in MM. Combined treatment effects of daratumumab, bortezomib (Velcade), and dexamethasone (Decadron) or the D-Vd regimen have been previously studied in the CASTOR trial. There was a significant improvement in survival without cancer worsening with D-Vd compared to Vd alone. 

Patient-reported outcomes (PROs) are used to assess the health status of patients during trials. The addition of drugs to a treatment regimen usually comes with added side effects and reduces HRQoL. The PROs of patients treated with D-Vd compared to Vd in the CASTOR trial are not known.

This study included 498 patients with RRMM. Patients received either D-Vd (251 patients) or Vd (247 patients) treatment. All patients received 8 cycles of Vd. Patients in the D-Vd group received daratumumab once weekly in cycles 1-3, on day 1 of cycles 4-8, then every 4 weeks until disease progression or unacceptable toxicity. Standardized questionnaires were used to collect data about the HRQoL.

There was no change in the patients’ HRQoL for the first 8 therapy cycles. However, after these 8 cycles, the D-Vd group showed long-term improvements in global health status and pain.

The authors concluded that there were no reductions in HRQoL for the first 8 therapy cycles, while daratumumab was associated with long-term improvements in global health scores and pain.

PROs were not assessed as the main outcome. More patients in the Vd group stopped treatment early. Also, after the 8 cycles, PROs were only evaluated for the D-Vd group.