QoL during KTd or KRd induction followed by K maintenance or observation in transplant noneligible patients with newly diagnosed multiple myeloma: Longitudinal and cross‐sectional analysis of the randomized AGMT 02 study
Heinz Ludwig,
Thomas Melchardt,
Ilvy Schweitzer,
Siegfried Sormann,
Martin Schreder,
Johannes Andel,
Bernd Hartmann,
Niklas Zojer,
Laurenz Schöffmann,
Eberhard Gunsilius,
Klaus Podar,
Alexander Egle,
Wolfgang Willenbacher,
Ewald Wöll,
Reinhard Ruckser,
Boris Bozic,
Maria‐Theresa Krauth,
Andreas Petzer,
Clemens Schmitt,
Sigrid Machherndl‐Spandl,
Hermine Agis,
Michael Fillitz,
Song‐Yau Wang,
Stefan Knop,
Richard Greil
Affiliations
Heinz Ludwig
Wilhelminen Cancer Research Institute c/o Department of Medicine I, Clinic Ottakring Vienna Austria
Thomas Melchardt
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute – Laboratory for Immunological and Molecular Cancer Research (SCRI‐LIMCR), Paracelsus Medical University Cancer Cluster Salzburg Salzburg Austria
Ilvy Schweitzer
Wilhelminen Cancer Research Institute c/o Department of Medicine I, Clinic Ottakring Vienna Austria
Siegfried Sormann
Department of Hematology University Clinic for Internal Medicine Graz Austria
Martin Schreder
Department of Medicine I Clinic Ottakring Vienna Austria
Johannes Andel
Department of Internal Medicine II Pyhrn‐Eisenwurzen Klinikum Steyr Steyr Austria
Bernd Hartmann
Department of Internal Medicine II LKH Rankweil Salzburg Austria
Niklas Zojer
Department of Medicine I Clinic Ottakring Vienna Austria
Laurenz Schöffmann
Department for Hematology, Oncology and Palliative Care LKH Hochsteiermark, Standort Leoben Leoben Austria
Eberhard Gunsilius
Department of Internal Medicine V Medical University Innsbruck Innsbruck Austria
Klaus Podar
Department of Internal Medicine II, University Hospital Krems; and Molecular Oncology and Hematology Unit Karl Landsteiner University of Health Sciences, Krems an der Donau Krems Austria
Alexander Egle
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute – Laboratory for Immunological and Molecular Cancer Research (SCRI‐LIMCR), Paracelsus Medical University Cancer Cluster Salzburg Salzburg Austria
Wolfgang Willenbacher
Department of Internal Medicine V Medical University Innsbruck Innsbruck Austria
Ewald Wöll
Department of Internal Medicine St. Vinzenz Krankenhaus Zams Zams Austria
Reinhard Ruckser
Department of Medicine II Clinic Donaustadt Vienna Austria
Boris Bozic
Department of Medicine II Clinic Donaustadt Vienna Austria
Maria‐Theresa Krauth
University Clinic for Internal Medicine I AKH, Medical University of Vienna Vienna Austria
Andreas Petzer
Department of Internal Medicine I BHS Linz Linz Austria
Clemens Schmitt
Clinic for Internal Medicine 3 Kepler University Clinic Linz Linz Austria
Sigrid Machherndl‐Spandl
Department of Internal Medicine I Elisabethinen, Linz Linz Austria
Hermine Agis
Department of Internal Medicine I, Division of Oncology Medical University Vienna Vienna Austria
Michael Fillitz
Department of Internal Medicine Hanusch Krankenhaus Vienna Austria
Song‐Yau Wang
Medical Clinic and Policlinic I University Clinic Leipzig Leipzig Germany
Stefan Knop
Klinik für Innere Medizin 5, Schwerpunkt Onkologie/Hämatologie Klinikum Nürnberg Nord Nürnberg Germany
Richard Greil
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute – Laboratory for Immunological and Molecular Cancer Research (SCRI‐LIMCR), Paracelsus Medical University Cancer Cluster Salzburg Salzburg Austria
Abstract Understanding the impact of induction and maintenance therapy on patients’ quality of life (QoL) is important for treatment selection. This study aims to compare patient‐reported QoL between patients treated with KTd or KRd induction therapy and K maintenance therapy or observation. QoL was assessed using the EORTC QOL‐C 30 and QOL‐MY20 questionnaires in the AGMT‐02 study, in which 123 patients with newly diagnosed transplant ineligible multiple myeloma were randomized to nine cycles of either KTd or KRd induction therapy, followed by 12 cycles of K maintenance therapy, or observation. Longitudinal assessments showed statistically significant improvements in global health‐related QoL, various disease symptoms and pain for both treatment regimens. KTd improved insomnia and fatigue, and KRd improved physical functioning. Cross‐sectional comparisons indicated a “slight” superiority of KTd over KRd in several scales, with the exception of higher neuropathy scores with KTd. During maintenance, longitudinal comparisons showed no statistically significant changes. Cross‐sectional comparisons revealed a “slight” improvement in cognitive functioning during carfilzomib therapy, but a worsening in most other QoL scales. Induction therapy led to improvements in most QoL items, while maintenance therapy with K maintenance was associated with “slight” or “moderate” impairments in several QoL scales compared with the observation group.