Significance of health related quality of life to confirm the benefits of D-VMP therapy in patients with newly diagnosed multiple myeloma

The study reports the outcomes of cancer treatment on the health-related quality of life (HRQoL) in patients with newly diagnosed multiple myeloma (MM) who were not eligible for a stem cell transplant (SCT). This study showed that treatment with VMP (bortezomib, melphalan, and prednisone) with or without daratumumab (Darzalex) improved the HRQoL in these patients. 

Patients with multiple myeloma (MM) experience high levels of pain, tiredness, and mood disturbances. Therefore, they experience a significant decrease in the HRQoL. The first line of treatment for MM is usually a SCT. However, some patients are not eligible for a SCT due to increased risks. These patients face an even higher impact on the quality of life. This is commonly due to their growing age and additional health conditions.

A recent study showed that the combination of daratumumab (D) and VMP significantly improved overall treatment response rate and survival without worsening of disease in patients with newly diagnosed MM that were not eligible for a SCT compared to VMP alone. However, the HRQoL outcomes of D-VMP vs VMP are unknown.

706 patients with newly diagnosed MM who were ineligible for SCT were selected for the study. Patients were randomly assigned to D-VMP or VMP. HRQoL was evaluated through standardized questionnaires for up to 3 years. Questionnaires were used to score the functioning (physical, emotional, thinking, social, and role functioning) and symptoms (fatigue, nausea and vomiting, pain, shortness of breath, insomnia, and appetite loss, among others) in patients.

Both groups showed continuous improvements in HRQoL. Slight improvements were seen in the D-VMP group compared to the VMP alone group at all time points. However, these were not found statistically significant. Improvements were seen in pain, tiredness, nausea, and vomiting. 75% of the D-VMP group and 71% of the VMP alone group had significant improvements in HRQoL scores.

Both groups reported slight reductions in cognitive (thinking and reasoning) function scores.

The study concluded that the HRQoL of patients with newly diagnosed MM was improved and maintained on treatment with both D-VMP or VMP. 

Patients in this study knew what treatment they were receiving. This might have influenced responses to questionnaires. Also, some patients were lost to follow-up. This might have impacted the results.