Health-related quality of life in multiple myeloma patients with first relapse treated with Carfilzomib-based re-induction and salvage high-dose chemotherapy with stem-cell support: preliminary data from the CARFI trial (NMSG 20/13)

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Resumé

Background
In multiple myeloma (MM), high-dose chemotherapy with stem-cell support (HDT) has improved disease free and overall survival in younger newly diagnosed patients without significant effect on health-related quality of life (HR-QoL). Fit relapsed MM patients are often considered for re-induction chemotherapy and salvage HDT. However, the impact of such potentially toxic treatment on HR-QoL is unknown. Therefore, the aim of this study was to evaluate HR-QoL in relapsed HDT-eligible MM patients undergoing a second HDT after re-induction with Carfilzomib-Cyclophosphamide-Dexamethasone (Car-Cy-Dex).

Methods
Transplant-eligible MM patients with first relapse after primary HDT were treated with four cycles of Car-Cy-Dex and salvage HDT including two doses of Car. Two months post-salvage HDT, HR-QoL was evaluated with patient-reported questionnaires (EORTC QLQ-C30, QLQ-MY20, and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) subscale). The QLQ-C30 data were compared with age-matched Danish normative data and interpreted according to statistical significance (p<0.01) and clinical relevant differences (according to Cocks et al., 2011).

Results
Ninety-two MM patients (males=57), median age of 62 years (range 43-73) were analyzed. Median time from first HDT was 4.0 years (range 1-11). Patients´ ECOG performance status was 0 in 49 (53%), 1 in 30 (33%), 2 in 1 (1%), and missing for 12 (13%). Completion rates for the EORTC and FACT/GOG-Ntx questionnaires were 100 and 87%, respectively. Patients reported clinical significant worse HR-QoL in 9 out of 14 QLQ-C30 subscales compared with the reference material. The most affected QLQ-MY20 subscale was Future Perspectives. The FACT-GOG-Ntx sub-scale score revealed no clinically meaningful neuropathy.

Conclusions
In younger MM patients with first relapse after primary HDT, Car-Cy-Dex re-induction chemotherapy and salvage HDT was not associated with neurotoxicity of clinical relevance. Expected short-term effects of clinical significant relevance in several aspects of HR-QoL were reported. Whether these findings are long-lasting will be clarified in the planned long-term follow-up analysis.
OriginalsprogEngelsk
Publikationsdato6. sep. 2018
StatusUdgivet - 6. sep. 2018

Fingeraftryk

Quality of Life
Induction Chemotherapy
carfilzomib
Poisons
Disease-Free Survival
Neoplasms

Citer dette

@conference{8568dc4fd80f4ef6bbd232dfeb4dd6d3,
title = "Health-related quality of life in multiple myeloma patients with first relapse treated with Carfilzomib-based re-induction and salvage high-dose chemotherapy with stem-cell support: preliminary data from the CARFI trial (NMSG 20/13)",
abstract = "BackgroundIn multiple myeloma (MM), high-dose chemotherapy with stem-cell support (HDT) has improved disease free and overall survival in younger newly diagnosed patients without significant effect on health-related quality of life (HR-QoL). Fit relapsed MM patients are often considered for re-induction chemotherapy and salvage HDT. However, the impact of such potentially toxic treatment on HR-QoL is unknown. Therefore, the aim of this study was to evaluate HR-QoL in relapsed HDT-eligible MM patients undergoing a second HDT after re-induction with Carfilzomib-Cyclophosphamide-Dexamethasone (Car-Cy-Dex).MethodsTransplant-eligible MM patients with first relapse after primary HDT were treated with four cycles of Car-Cy-Dex and salvage HDT including two doses of Car. Two months post-salvage HDT, HR-QoL was evaluated with patient-reported questionnaires (EORTC QLQ-C30, QLQ-MY20, and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) subscale). The QLQ-C30 data were compared with age-matched Danish normative data and interpreted according to statistical significance (p<0.01) and clinical relevant differences (according to Cocks et al., 2011). ResultsNinety-two MM patients (males=57), median age of 62 years (range 43-73) were analyzed. Median time from first HDT was 4.0 years (range 1-11). Patients´ ECOG performance status was 0 in 49 (53{\%}), 1 in 30 (33{\%}), 2 in 1 (1{\%}), and missing for 12 (13{\%}). Completion rates for the EORTC and FACT/GOG-Ntx questionnaires were 100 and 87{\%}, respectively. Patients reported clinical significant worse HR-QoL in 9 out of 14 QLQ-C30 subscales compared with the reference material. The most affected QLQ-MY20 subscale was Future Perspectives. The FACT-GOG-Ntx sub-scale score revealed no clinically meaningful neuropathy.ConclusionsIn younger MM patients with first relapse after primary HDT, Car-Cy-Dex re-induction chemotherapy and salvage HDT was not associated with neurotoxicity of clinical relevance. Expected short-term effects of clinical significant relevance in several aspects of HR-QoL were reported. Whether these findings are long-lasting will be clarified in the planned long-term follow-up analysis.",
author = "{Rode Eshoj}, Henrik and {Kongsgaard Nielsen}, Lene and Niels Abildgaard",
year = "2018",
month = "9",
day = "6",
language = "English",

}

TY - ABST

T1 - Health-related quality of life in multiple myeloma patients with first relapse treated with Carfilzomib-based re-induction and salvage high-dose chemotherapy with stem-cell support: preliminary data from the CARFI trial (NMSG 20/13)

AU - Rode Eshoj, Henrik

AU - Kongsgaard Nielsen, Lene

AU - Abildgaard , Niels

PY - 2018/9/6

Y1 - 2018/9/6

N2 - BackgroundIn multiple myeloma (MM), high-dose chemotherapy with stem-cell support (HDT) has improved disease free and overall survival in younger newly diagnosed patients without significant effect on health-related quality of life (HR-QoL). Fit relapsed MM patients are often considered for re-induction chemotherapy and salvage HDT. However, the impact of such potentially toxic treatment on HR-QoL is unknown. Therefore, the aim of this study was to evaluate HR-QoL in relapsed HDT-eligible MM patients undergoing a second HDT after re-induction with Carfilzomib-Cyclophosphamide-Dexamethasone (Car-Cy-Dex).MethodsTransplant-eligible MM patients with first relapse after primary HDT were treated with four cycles of Car-Cy-Dex and salvage HDT including two doses of Car. Two months post-salvage HDT, HR-QoL was evaluated with patient-reported questionnaires (EORTC QLQ-C30, QLQ-MY20, and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) subscale). The QLQ-C30 data were compared with age-matched Danish normative data and interpreted according to statistical significance (p<0.01) and clinical relevant differences (according to Cocks et al., 2011). ResultsNinety-two MM patients (males=57), median age of 62 years (range 43-73) were analyzed. Median time from first HDT was 4.0 years (range 1-11). Patients´ ECOG performance status was 0 in 49 (53%), 1 in 30 (33%), 2 in 1 (1%), and missing for 12 (13%). Completion rates for the EORTC and FACT/GOG-Ntx questionnaires were 100 and 87%, respectively. Patients reported clinical significant worse HR-QoL in 9 out of 14 QLQ-C30 subscales compared with the reference material. The most affected QLQ-MY20 subscale was Future Perspectives. The FACT-GOG-Ntx sub-scale score revealed no clinically meaningful neuropathy.ConclusionsIn younger MM patients with first relapse after primary HDT, Car-Cy-Dex re-induction chemotherapy and salvage HDT was not associated with neurotoxicity of clinical relevance. Expected short-term effects of clinical significant relevance in several aspects of HR-QoL were reported. Whether these findings are long-lasting will be clarified in the planned long-term follow-up analysis.

AB - BackgroundIn multiple myeloma (MM), high-dose chemotherapy with stem-cell support (HDT) has improved disease free and overall survival in younger newly diagnosed patients without significant effect on health-related quality of life (HR-QoL). Fit relapsed MM patients are often considered for re-induction chemotherapy and salvage HDT. However, the impact of such potentially toxic treatment on HR-QoL is unknown. Therefore, the aim of this study was to evaluate HR-QoL in relapsed HDT-eligible MM patients undergoing a second HDT after re-induction with Carfilzomib-Cyclophosphamide-Dexamethasone (Car-Cy-Dex).MethodsTransplant-eligible MM patients with first relapse after primary HDT were treated with four cycles of Car-Cy-Dex and salvage HDT including two doses of Car. Two months post-salvage HDT, HR-QoL was evaluated with patient-reported questionnaires (EORTC QLQ-C30, QLQ-MY20, and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) subscale). The QLQ-C30 data were compared with age-matched Danish normative data and interpreted according to statistical significance (p<0.01) and clinical relevant differences (according to Cocks et al., 2011). ResultsNinety-two MM patients (males=57), median age of 62 years (range 43-73) were analyzed. Median time from first HDT was 4.0 years (range 1-11). Patients´ ECOG performance status was 0 in 49 (53%), 1 in 30 (33%), 2 in 1 (1%), and missing for 12 (13%). Completion rates for the EORTC and FACT/GOG-Ntx questionnaires were 100 and 87%, respectively. Patients reported clinical significant worse HR-QoL in 9 out of 14 QLQ-C30 subscales compared with the reference material. The most affected QLQ-MY20 subscale was Future Perspectives. The FACT-GOG-Ntx sub-scale score revealed no clinically meaningful neuropathy.ConclusionsIn younger MM patients with first relapse after primary HDT, Car-Cy-Dex re-induction chemotherapy and salvage HDT was not associated with neurotoxicity of clinical relevance. Expected short-term effects of clinical significant relevance in several aspects of HR-QoL were reported. Whether these findings are long-lasting will be clarified in the planned long-term follow-up analysis.

M3 - Conference abstract for conference

ER -