How does daratumumab with lenalidomide and dexamethasone impact the quality of life of patients with multiple myeloma?

This study investigated the impact of the D-Rd regimen including daratumumab (Darzalex) combined with lenalidomide (Revlimid) and dexamethasone (Decadron) on the quality of life of patients with multiple myeloma (MM) who cannot undergo a transplant. The study showed that patients who received D-Rd reported lower levels of pain and a better quality of life after therapy.

MM is a type of blood cancer. The standard therapy for patients who are diagnosed with MM is chemotherapy and a stem cell transplant. Some patients are not eligible for a transplant and receive other therapy. Lenalidomide plus dexamethasone (Rd) is one treatment option for these patients. Daratumumab is an immunotherapy which directly targets the cancer cells to kill them. Daratumumab combined with the Rd regimen (D-Rd) has been previously shown to reduce the risk of disease progression.

While patients with MM have been shown to respond to D-Rd, patients can experience side effects. These patients often need therapy for a long time. The impact that D-Rd has on patients’ quality of life is not yet clear. 

This study included 737 patients with MM who were not eligible for a stem cell transplant. 369 patients were randomly assigned to receive Rd and 368 to D-Rd. Patients completed questionnaires to assess how therapy affected their quality of life. The average follow-up was 28 months. 

Patients in both groups reported improvements in quality of life following treatment. Patients who received D-Rd reported lower pain, less fatigue, and better physical functioning. These improvements were seen after the 3rd cycle of treatment. 

The study found that patients with MM not eligible for a transplant in the D-Rd group were more likely to experience an improvement in the quality of life than those in the Rd group.

This study did not compare changes in quality of life between groups. The patients knew which treatment they had been given which might have affected their questionnaires. This study was funded by Janssen Research & Development, the manufacturer of daratumumab.