Maintenance therapy after autologous stem-cell transplant (ASCT) has demonstrated extended time to progression and progression-free survival for patients with multiple myeloma (MM). However, maintenance treatment until progression has the potential to adversely impact health-related quality of life (HRQoL). Using data from the Connect MM registry, Abonour and colleagues evaluated HRQoL of patients based on maintenance treatment status.
Patients ≥18 years who completed induction therapy and first-line ASCT who may or may not have gone on to receive maintenance were included in the analysis. Patients were evaluated in 3 groups: (1) Any maintenance (including lenalidomide [LEN]-only), (2) LEN-only maintenance, and (3) No maintenance.
Patient-reported HRQoL data were collected at protocol-defined quarterly visits, using the EQ-5D Index score. Secondary measures included the Functional Assessment of Cancer Therapy–Multiple Myeloma (FACT-MM) total score and the Brief Pain Inventory (BPI). HRQoL assessments were analyzed at study entry (study baseline); after induction therapy but prior to ASCT; and quarterly from 100 days post-ASCT until the end of maintenance or until progressive disease, discontinuation, or death.
Of the 540 patients who received ASCT, 238 (44%) met the analysis criteria for Any maintenance, 167 (31%) for LEN-only, and 138 (26%) for No maintenance. A higher proportion of patients in the Any and LEN-only maintenance groups received triplet therapy as induction versus the No maintenance group (64%, 66%, and 51%, respectively). The median number of EQ-5D forms completed per patient and the mean baseline HRQoL scores for each measure were comparable across the 3 groups. Researchers found no significant differences in estimated mean post-ASCT scores when comparing Any or LEN-only with the No maintenance group for the EQ-5D Overall Index, the FACT-MM Total Score, or the BPI.
Given that HRQoL scores were similar across the 3 groups for the 3 measures studied, the authors concluded that patient quality of life is not substantially impacted by maintenance therapy despite the inherent risks associated with continued active therapy.
Abonour R, et al. ASH 2016. Abstract 537.