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Mainou M, Tsapa K, Michailidis T, Malandris K, Karagiannis T, Avgerinos I, Liakos A, Papaioannou M, Terpos E, Prasad V, Tsapas A. Outcomes in Randomized Controlled Trials of Therapeutic Interventions for Multiple Myeloma: a Systematic Review. Crit Rev Oncol Hematol 2024:104529. [PMID: 39368634 DOI: 10.1016/j.critrevonc.2024.104529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 09/30/2024] [Accepted: 10/01/2024] [Indexed: 10/07/2024] Open
Abstract
PURPOSE Many clinical trials of therapeutic interventions for multiple myeloma do not use patient important outcomes and rely on the use of surrogate endpoints. The aim of this systematic review was to depict the landscape of randomized controlled trials in myeloma research and compile the endpoints utilized. METHODS We searched Embase, PubMed, and the Cochrane Library for randomized controlled trials in myeloma published in English up to October 2023. We included trials exploring efficacy of therapeutic modalities for myeloma itself or supportive care interventions. RESULTS A total of 2181 records, reporting data from 624 trials (448 comparing anti-myeloma treatments and 176 comparing supportive interventions) were deemed eligible. The most common primary outcome reported was disease response, followed by progression free survival (PFS) and overall survival (OS). Across all trials, 119 (19.1%) used OS as the primary endpoint, while 316 (50,6%) listed it as a secondary endpoint. Quality of life was less commonly prioritized, featured as primary endpoint only in seven studies (1.1%) and as secondary endpoint in 115 studies (18.4%). Studies funded by the pharmaceutical industry were more likely (Odds Ratio [OR] 3.85, 95% CI 2.41 to 6.35) to use PFS as primary outcome. Similarly, studies with authors that had conflicts of interest with the funding source were more likely (OR 4.57, 95% CI 2.72 to 7.92) to use PFS as the primary outcome. CONCLUSION While randomized controlled trials for multiple myeloma predominantly rely on surrogate endpoints, particularly PFS, the importance of OS as an outcome should not be overlooked.
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Affiliation(s)
- Maria Mainou
- Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Kalliopi Tsapa
- Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Michailidis
- First Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Malandris
- Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Karagiannis
- Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Avgerinos
- Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aris Liakos
- Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Papaioannou
- Hematology Unit, First Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | - Evangelos Terpos
- National and Kapodistrian University of Athens - Faculty of Medicine, Department of Clinical Therapeutics, Plasma Cell Dyscrasias Unit, Alexandra General Hospital, Athens, Greece
| | - Vinay Prasad
- University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, US
| | - Apostolos Tsapas
- Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece; Harris Manchester College, University of Oxford, Oxford, UK
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Buck C, Brenes Castillo F, Bettio E, Land J, McCourt O, Poole H, Tarling R, Yong K, Popat R, Lee L, McMillan A, Papanikolaou X, Xu K, Kyriakou C, Rabin N, Wechalekar A, Fisher A, Sive J. The impact of continuous lenalidomide maintenance treatment on people living with multiple myeloma-a single-centre, qualitative service evaluation study. Support Care Cancer 2024; 32:479. [PMID: 38954025 PMCID: PMC11219377 DOI: 10.1007/s00520-024-08663-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Continuous lenalidomide maintenance treatment after autologous stem cell transplantation delivers improvement in progression free and overall survival among newly diagnosed multiple myeloma patients and has been the standard of care in the UK since March 2021. However, there is scant information about its impact on patients' day-to-day lives. This service evaluation aimed to qualitatively assess patients receiving lenalidomide treatment at a cancer centre in London, in order that the service might better align with needs and expectations of patients. METHODS We conducted 20 semi-structured interviews among myeloma patients who were on continuous lenalidomide maintenance treatment at a specialist cancer centre in London. Members of the clinical team identified potentially eligible participants to take part, and convenience sampling was used to select 10 male and 10 female patients, median age of 58 (range, 45-71). The median treatment duration was 11 months (range, 1-60 months). Participants were qualitatively interviewed following the same semi-structured interview guide, which was designed to explore patient experience and insights of lenalidomide. Reflexive thematic analysis was used for data analysis. RESULTS Four overarching themes were as follows: (i) lenalidomide: understanding its role and rationale; (ii) reframing the loss of a treatment-free period to a return to normal life; (iii) the reality of being on lenalidomide: balancing hopes with hurdles; (iv) gratitude and grievances: exploring mixed perceptions of care and communication. Results will be used to enhance clinical services by tailoring communication to better meet patients' preferences when making treatment decisions. CONCLUSION This study highlights that most patients feel gratitude for being offered continuous lenalidomide and perceive it as alleviating some fears concerning relapse. It reveals variations in side effects in different age groups; younger patients reported no/negligible side effects, whilst several older patients with comorbidities described significant symptom burden, occasionally leading to treatment discontinuation which caused distress at the perceived loss of prolonged remission. Future research should prioritise understanding the unique needs of younger patients living with multiple myeloma.
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Affiliation(s)
- Caroline Buck
- Institute of Epidemiology and Health, University College London, London, UK.
| | | | - Elena Bettio
- Institute of Epidemiology and Health, University College London, London, UK
| | - Joanne Land
- Haematology Department, University College London Hospital, London, UK
- Research Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - Orla McCourt
- Haematology Department, University College London Hospital, London, UK
- Research Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - Helen Poole
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Rachel Tarling
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Kwee Yong
- Haematology Department, University College London Hospital, London, UK
- Research Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - Rakesh Popat
- Haematology Department, University College London Hospital, London, UK
- Research Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - Lydia Lee
- Haematology Department, University College London Hospital, London, UK
- Research Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - Annabel McMillan
- Haematology Department, University College London Hospital, London, UK
| | | | - Ke Xu
- Haematology Department, University College London Hospital, London, UK
| | - Chara Kyriakou
- Haematology Department, University College London Hospital, London, UK
| | - Neil Rabin
- Haematology Department, University College London Hospital, London, UK
| | - Ashu Wechalekar
- Haematology Department, University College London Hospital, London, UK
| | - Abigail Fisher
- Institute of Epidemiology and Health, University College London, London, UK
| | - Jonathan Sive
- Haematology Department, University College London Hospital, London, UK
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3
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Silbermann R, Laubach J, Kaufman JL, Sborov DW, Reeves B, Rodriguez C, Chari A, Costa LJ, Anderson LD, Nathwani N, Shah N, Bumma N, Holstein SA, Costello C, Jakubowiak A, Orlowski RZ, Shain KH, Cowan AJ, Gries KS, Pei H, Cortoos A, Patel S, Lin TS, Voorhees PM, Usmani SZ, Richardson PG. Health-related quality of life in transplant-eligible patients with newly diagnosed multiple myeloma treated with daratumumab, lenalidomide, bortezomib, and dexamethasone: Patient-reported outcomes from GRIFFIN. Am J Hematol 2024; 99:1257-1268. [PMID: 38622840 DOI: 10.1002/ajh.27326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/07/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
In the phase 2 GRIFFIN trial (ClinicalTrials.gov identifier: NCT02874742), daratumumab added to lenalidomide, bortezomib, and dexamethasone (D-RVd) improved depth of response and progression-free survival (PFS) versus lenalidomide, bortezomib, and dexamethasone (RVd) alone in transplant-eligible (TE) patients with newly diagnosed multiple myeloma (NDMM). Here, we present patient-reported outcomes (PROs) collected using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30-item (QLQ-C30), EORTC Quality of Life Questionnaire Multiple Myeloma Module 20-item (QLQ-MY20), and EuroQol 5-Dimension 5-Level (EQ-5D-5L) tools on day 1 of cycles 1, 2, and 3; on day 21 of cycle 4 (end of induction therapy); on day 1 of cycle 5; on day 21 of cycle 6 (end of posttransplant consolidation therapy); and at months 6, 12, 18, and 24 of maintenance therapy. Meaningful improvements from baseline were seen in most of the PRO scales with both treatments after consolidation and were sustained for at least 2 years of maintenance treatment. Large reductions from baseline (~20 points) were especially observed in pain symptoms for both treatment groups, although these were numerically higher for patients receiving D-RVd during the majority of the time points. In addition, improvements in key scales, such as global health status, fatigue symptoms, and physical functioning, were also seen with both D-RVd and RVd. These improvements in health-related quality of life contribute to the totality of evidence supporting the improvement in clinical outcomes such as response rates and PFS with D-RVd in induction, consolidation, and maintenance therapy in TE patients with NDMM.
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Affiliation(s)
- Rebecca Silbermann
- Division of Hematology/Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Jacob Laubach
- Department of Medical Oncology, Dana-Farber/Partners Cancer Care, Boston, Massachusetts, USA
| | - Jonathan L Kaufman
- Department of Mematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Douglas W Sborov
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Brandi Reeves
- Division of Hematology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cesar Rodriguez
- Department of Hematology and Medical Oncology, Mount Sinai School of Medicine, New York, New York, USA
| | - Ajai Chari
- Department of Hematology and Medical Oncology, Mount Sinai School of Medicine, New York, New York, USA
| | - Luciano J Costa
- Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Larry D Anderson
- Division of Hematology/Oncology, Simmons Comprehensive Cancer Center, UT Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nitya Nathwani
- Division of Myeloma, Judy and Bernard Briskin Center for Multiple Myeloma Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Nina Shah
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Naresh Bumma
- Division of Hematology, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Sarah A Holstein
- Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Caitlin Costello
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Andrzej Jakubowiak
- Medicine- Hematology and Oncology, University of Chicago, Chicago, Illinois, USA
| | - Robert Z Orlowski
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kenneth H Shain
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Andrew J Cowan
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Huiling Pei
- Janssen Research & Development, LLC, Titusville, New Jersey, USA
| | | | - Sharmila Patel
- Janssen Scientific Affairs, LLC, Horsham, Pennsylvania, USA
| | - Thomas S Lin
- Janssen Scientific Affairs, LLC, Horsham, Pennsylvania, USA
| | - Peter M Voorhees
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health/Wake Forest University School of Medicine, Charlotte, North Carolina, USA
| | - Saad Z Usmani
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Paul G Richardson
- Department of Medical Oncology, Dana-Farber/Partners Cancer Care, Boston, Massachusetts, USA
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Schjesvold FH, Ludwig H, Delimpasi S, Robak P, Coriu D, Tomczak W, Pour L, Spicka I, Dimopoulos MA, Masszi T, Chernova NG, Sandberg A, Thuresson M, Norin S, Bakker NA, Mateos MV, Richardson PG, Sonneveld P. Health-related quality of life in relapsed/refractory multiple myeloma treated with melflufen and dexamethasone: analyses from the phase III OCEAN study. Haematologica 2024; 109:2331-2336. [PMID: 38426292 PMCID: PMC11215352 DOI: 10.3324/haematol.2023.284635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Affiliation(s)
- Fredrik H Schjesvold
- Oslo Myeloma Center, Department of Hematology, Oslo University Hospital and KG Jebsen Center for B Cell Malignancies, University of Oslo, Oslo, Norway.
| | - Heinz Ludwig
- Department of Medicine I, Center for Medical Oncology and Hematology with Outpatient Department and Palliative Care, Wilhelminen Cancer Research Institute, Vienna
| | - Sossana Delimpasi
- Bone Marrow Transplantation Unit and Department of Hematology, Evangelismos Hospital, Athens, Greece
| | - Pawel Robak
- Department of Hemato-Oncology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Daniel Coriu
- University of Medicine and Pharmacy "Carol Davila", Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Waldemar Tomczak
- Department of Hemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin
| | - Ludek Pour
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Babak Myeloma Group, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ivan Spicka
- 1st Department of Medicine - Department of Hematology, First Faculty of Medicine, Charles University and General Hospital in Prague, Prague, Czech Republic
| | | | - Tamas Masszi
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
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Malard F, Neri P, Bahlis NJ, Terpos E, Moukalled N, Hungria VTM, Manier S, Mohty M. Multiple myeloma. Nat Rev Dis Primers 2024; 10:45. [PMID: 38937492 DOI: 10.1038/s41572-024-00529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/29/2024]
Abstract
Multiple myeloma (MM) is a haematological lymphoid malignancy involving tumoural plasma cells and is usually characterized by the presence of a monoclonal immunoglobulin protein. MM is the second most common haematological malignancy, with an increasing global incidence. It remains incurable because most patients relapse or become refractory to treatments. MM is a genetically complex disease with high heterogeneity that develops as a multistep process, involving acquisition of genetic alterations in the tumour cells and changes in the bone marrow microenvironment. Symptomatic MM is diagnosed using the International Myeloma Working Group criteria as a bone marrow infiltration of ≥10% clonal plasma cells, and the presence of at least one myeloma-defining event, either standard CRAB features (hypercalcaemia, renal failure, anaemia and/or lytic bone lesions) or biomarkers of imminent organ damage. Younger and fit patients are considered eligible for transplant. They receive an induction, followed by consolidation with high-dose melphalan and autologous haematopoietic cell transplantation, and maintenance therapy. In older adults (ineligible for transplant), the combination of daratumumab, lenalidomide and dexamethasone is the preferred option. If relapse occurs and requires further therapy, the choice of therapy will be based on previous treatment and response and now includes immunotherapies, such as bi-specific monoclonal antibodies and chimeric antigen receptor T cell therapy.
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Affiliation(s)
- Florent Malard
- Sorbonne Université, Centre de Recherche Saint-Antoine INSERM UMRs938, Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France.
| | - Paola Neri
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
| | - Nizar J Bahlis
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
| | - Evangelos Terpos
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Nour Moukalled
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Salomon Manier
- Department of Hematology, Lille University Hospital and INSERM UMR-S1277 and CNRS UMR9020, Lille, France
| | - Mohamad Mohty
- Sorbonne Université, Centre de Recherche Saint-Antoine INSERM UMRs938, Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France.
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6
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Ojo AS, Araoye MO, Ali A, Sarma R. The impact of current therapeutic options on the health-related quality of life of patients with relapse/refractory multiple myeloma: a systematic review of clinical studies. J Cancer Surviv 2024; 18:673-697. [PMID: 36645615 DOI: 10.1007/s11764-023-01332-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/05/2023] [Indexed: 01/17/2023]
Abstract
PURPOSE Patients with relapse and/or refractory multiple myeloma (RRMM) have a high disease burden with poor health-related quality of life (HRQoL) which worsens with each additional relapse. We aimed to review the impact of triplet, doublet, monotherapies, and salvage autologous stem cell transplantation on the HRQoL of RRMM patients. METHODS We performed a comprehensive literature search of Medline/PubMed, Wiley Cochrane Library, EMBASE, Scopus, CINAHL, and Clinicaltrials.gov to identify clinical studies in RRMM patients with HRQoL as an outcome measure. The ISOQoL and CONSORT-PRO extension guidelines were used to assess the quality of HRQoL reporting. We synthesized the result using a qualitative analysis. RESULTS A total of 10,245 RRMM patients enrolled in 28 eligible studies received either a triplet, doublet regimen, monotherapy, or salvage autologous stem cell transplantation. The EORTC QLQ-C30 was the most used questionnaire, and compliance with HRQoL reporting standards is generally poor among studies without an additional HRQoL publication. Most of the current therapeutic options are at best able to maintain HRQoL at baseline but not improve it. The methodological and reporting heterogeneity among the studies complicates generalizations. CONCLUSIONS Many of the current treatment regimens for RRMM have demonstrated clinical effectiveness in trials. Unlike newly diagnosed MM, these regimens are less likely to result in significant improvement in HRQoL in RRMM. This should be communicated to patients before initiating therapies. IMPLICATIONS FOR CANCER SURVIVORS Individualized therapeutic approach for RRMM should be chosen based on a shared decision-making process that aligns clinical efficacy with patients' treatment priorities and HRQoL.
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Affiliation(s)
- Ademola S Ojo
- Department of Internal Medicine, Howard University Hospital, 2041 Georgia Ave. NW, Washington, DC, USA.
| | - Mojisola O Araoye
- Hematology/Oncology Division, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ahmed Ali
- Department of Medicine, Hematology/Oncology Division, Howard University Hospital, Washington, DC, USA
| | - Ravi Sarma
- Department of Medicine, Hematology/Oncology Division, Howard University Hospital, Washington, DC, USA
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Mohty M, Bahlis NJ, Nooka AK, DiBonaventura M, Ren J, Conte U. Impact of elranatamab on quality of life: Patient-reported outcomes from MagnetisMM-3. Br J Haematol 2024; 204:1801-1810. [PMID: 38420657 DOI: 10.1111/bjh.19346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 03/02/2024]
Abstract
The physical and emotional burden of relapsed or refractory multiple myeloma (RRMM) has been strongly correlated with declining health-related quality of life (QOL) in the patients it affects. This analysis evaluated patient-reported outcomes (PROs) from B-cell maturation antigen (BCMA)-naive (n = 123) and -exposed (n = 64) patients with RRMM enrolled in the MagnetisMM-3 study (NCT04649359) and treated with the humanized, bispecific BCMA-CD3 antibody elranatamab. Patients received two step-up doses of elranatamab (12 mg on day 1, 32 mg on day 4) before starting the full dose of 76 mg on day 8 (each cycle = 28 days). Global health status, functioning and symptom data were collected electronically using validated and myeloma-specific questionnaires. Improvements in PROs occurred early, with marked reductions in pain and disease symptoms and notable improvements in patients' outlook for their future health. Additionally, 40.2% of BCMA-naive and 52.6% of BCMA-exposed patients perceived their disease as 'a little better' or 'much better' by Cycle 1, Day 15. The results from this analysis demonstrated that elranatamab maintained or improved symptomology and general health status, regardless of prior BCMA-directed therapy. Thus, in addition to its clinical benefits, elranatamab therapy may sustain or improve QOL in heavily pretreated patients with RRMM.
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Affiliation(s)
- Mohamad Mohty
- Sorbonne University, Hôpital Saint-Antoine, and INSERM UMRS 938, Paris, France
| | - Nizar J Bahlis
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Alberta, Canada
| | - Ajay K Nooka
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | | | - Jinma Ren
- Pfizer Inc, Collegeville, Pennsylvania, USA
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Shawahna R, Amer R, Salameh H, Shawahna AR, Aljondy M, Zain-Aldain M. Adherence to the evidence-based recommendations in managing bone health, pain, and mobility of patients with multiple myeloma: a mixed method in the Palestinian healthcare system. BMC Cancer 2024; 24:301. [PMID: 38443861 PMCID: PMC10916152 DOI: 10.1186/s12885-024-12024-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 02/20/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Consensus/evidence-based recommendations for assessing, managing, and monitoring bone health, pain, and mobility in patients with multiple myeloma were developed. This study was conducted to assess the adherence of the hematologists-oncologists to the consensus/evidence-based recommendations for assessing, managing, and monitoring bone health, pain, and mobility in patients with multiple myeloma who received care in the Palestinian healthcare system. METHODS A mixed method was used in this study. The consensus/evidence-based recommendations were identified through a systematic search in Scopus, PubMed, SpringerLink, ScienceDirect, and Google Scholar. A panel of 5 researchers (3 hematologists-oncologists, 3 medical students, and 1 pharmacologist) sorted the consensus/evidence-based recommendations and developed the survey tool during 3 iterative meetings. The extent to which the hematologists-oncologists in the 5 centers caring for patients with multiple myeloma adhered to the consensus/evidence-based recommendations was assessed using a questionnaire. RESULTS Responses were collected from 10 hematologists-oncologists in all 5 healthcare centers where patients with multiple myeloma receive healthcare in the West Bank of Palestine. The median number of years in the practice of the hematologists-oncologists was 7.5 [2.75, 14.0] years and the median number of patients with multiple myeloma care per month was 12.5 [7.5, 21.25]. The vast majority (90%) of the hematologists-oncologists reported inadequate adherence to screening for medication problems related to bone health, pain, cardiopulmonary fitness, healthy behaviors, nutritional deficits, and mental health. Of the hematologists-oncologists, 70% reported inadequate adherence to ordering and evaluating calcium, vitamin D, alkaline phosphatase, electrolytes, and phosphorus levels to monitor bone health and 60% reported inadequate adherence to prescribing calcium and vitamin D supplements whenever there was a need. CONCLUSION The findings of this study suggested inadequate adherence to the consensus/evidence-based recommendations and highlighted areas for improvement to ensure that patients receive optimal care. The findings suggested a need for further education and training on the latest guidelines and recommendations. Decision-makers and policymakers might need to design measures and implement policies to improve adherence to the consensus/evidence-based recommendations. Addressing these gaps in adherence to the consensus/evidence-based recommendations may improve the care and outcomes of patients with multiple myeloma.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building: 19, Office: 1340, Nablus, P.O. Box 7, Palestine.
- Clinical Research Center, An-Najah National University Hospital, 44839, Nablus, Palestine.
| | - Riad Amer
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Hematology and Oncology, An-Najah National University Hospital, 44839, Nablus, Palestine
| | - Husam Salameh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Hematology and Oncology, An-Najah National University Hospital, 44839, Nablus, Palestine
| | - Abdul-Rahman Shawahna
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mohmmad Aljondy
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mohmmad Zain-Aldain
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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9
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Grieb N, Schmierer L, Kim HU, Strobel S, Schulz C, Meschke T, Kubasch AS, Brioli A, Platzbecker U, Neumuth T, Merz M, Oeser A. A digital twin model for evidence-based clinical decision support in multiple myeloma treatment. Front Digit Health 2023; 5:1324453. [PMID: 38173909 PMCID: PMC10761485 DOI: 10.3389/fdgth.2023.1324453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
The treatment landscape for multiple myeloma (MM) has experienced substantial progress over the last decade. Despite the efficacy of new substances, patient responses tend to still be highly unpredictable. With increasing cognitive burden that is introduced through a complex and evolving treatment landscape, data-driven assistance tools are becoming more and more popular. Model-based approaches, such as digital twins (DT), enable simulation of probable responses to a set of input parameters based on retrospective observations. In the context of treatment decision-support, those mechanisms serve the goal to predict therapeutic outcomes to distinguish a favorable option from a potential failure. In the present work, we propose a similarity-based multiple myeloma digital twin (MMDT) that emphasizes explainability and interpretability in treatment outcome evaluation. We've conducted a requirement specification process using scientific literature from the medical and methodological domains to derive an architectural blueprint for the design and implementation of the MMDT. In a subsequent stage, we've implemented a four-layer concept where for each layer, we describe the utilized implementation procedure and interfaces to the surrounding DT environment. We further specify our solutions regarding the adoption of multi-line treatment strategies, the integration of external evidence and knowledge, as well as mechanisms to enable transparency in the data processing logic. Furthermore, we define an initial evaluation scenario in the context of patient characterization and treatment outcome simulation as an exemplary use case for our MMDT. Our derived MMDT instance is defined by 475 unique entities connected through 438 edges to form a MM knowledge graph. Using the MMRF CoMMpass real-world evidence database and a sample MM case, we processed a complete outcome assessment. The output shows a valid selection of potential treatment strategies for the integrated medical case and highlights the potential of the MMDT to be used for such applications. DT models face significant challenges in development, including availability of clinical data to algorithmically derive clinical decision support, as well as trustworthiness of the evaluated treatment options. We propose a collaborative approach that mitigates the regulatory and ethical concerns that are broadly discussed when automated decision-making tools are to be included into clinical routine.
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Affiliation(s)
- Nora Grieb
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - Lukas Schmierer
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - Hyeon Ung Kim
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - Sarah Strobel
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - Christian Schulz
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - Tim Meschke
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - Anne Sophie Kubasch
- Department of Hematology, Hemostaseology, Cellular Therapy and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Annamaria Brioli
- Clinic of Internal Medicine C, Hematology and Oncology, Stem Cell Transplantation and Palliative Care, Greifswald University Medicine, Greifswald, Germany
| | - Uwe Platzbecker
- Department of Hematology, Hemostaseology, Cellular Therapy and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - Maximilian Merz
- Department of Hematology, Hemostaseology, Cellular Therapy and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Alexander Oeser
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
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Cardellino A, Correll JR, Martin M, Gorsh B, Sapra S, Popat R. Patient-reported experiences during and following treatment with belantamab mafodotin for relapsed/refractory multiple myeloma in the DREAMM-2 study. Front Oncol 2023; 13:1274659. [PMID: 38144529 PMCID: PMC10748584 DOI: 10.3389/fonc.2023.1274659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/08/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Patients with relapsed or refractory multiple myeloma (RRMM) are likely to be living with persistent symptoms, especially bone pain and fatigue, and experiencing restrictions in their physical and social functioning, which reduce health-related quality of life. Methods This qualitative interview study evaluated patients' perspectives about living with RRMM and their treatment with belantamab mafodotin, using interviews embedded in the Phase II DREAMM-2 trial (NCT03525678) with belantamab mafodotin. Patients consented to participate in up to 2 recorded telephone interviews (at treatment cycle 4 [C4] and at end of treatment [EOT]) comprising open-ended questions. Results A total of 142 interviews were conducted with 111 unique patients. At C4, common symptoms included neuropathy, fatigue, and bone or joint pain. Improvements in symptom severity were reported by patients who responded to belantamab mafodotin. Symptoms associated with visual impairment, eye irritation, and eye pain reported during the trial were reported to be at- or near-resolution by the EOT interview. Regarding impacts of underlying MM, patients most commonly expressed concerns about changes in daily performance and lifestyle for both responders (67.5% of all impact expressions) and non-responders (63.2%). Overall, interview participants reported being satisfied with belantamab mafodotin treatment. Discussion This qualitative patient interview study provides valuable insight into patients' symptomatic experience with belantamab mafodotin for their RRMM treatment and may help healthcare providers better anticipate their patients' real-world experience and needs when prescribing this novel agent in the clinic.
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Affiliation(s)
- Anna Cardellino
- Patient Centered Outcomes, GSK, Upper Providence, PA, United States
| | | | - Mona Martin
- Patient-Centered Research, Evidera, Seattle, WA, United States
| | - Boris Gorsh
- Patient Centered Outcomes, GSK, Upper Providence, PA, United States
| | - Sandhya Sapra
- Patient Centered Outcomes, GSK, Upper Providence, PA, United States
| | - Rakesh Popat
- NIHR/University College London Hospital Clinical Research Facility, NHS Foundation Trust, London, United Kingdom
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11
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Martínez-Lopez J, Bailey A, Lambert A, Luke E, Ribbands A, Erler-Yates N, Valluri S, Haefliger B, Gay F. Real-world treatment patterns, healthcare resource use and disease burden in patients with multiple myeloma in Europe. Future Oncol 2023; 19:2103-2121. [PMID: 37706245 DOI: 10.2217/fon-2023-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Aim: To investigate treatment patterns, healthcare resource utilization and disease burden in patients with multiple myeloma (MM). Methods: Point-in-time survey of physicians and their patients presenting in a real-world clinical setting, collected across Europe between May and November 2021. Results: In total, 173 physicians provided data for 2179 patients with MM. Treatments received became more diverse as line of therapy increased, dictated by previous treatment choices. Overall, 25% of all patients were tri-exposed, and experienced a higher degree of healthcare resource utilization, disease burden and impairment than non-tri-exposed patients. Conclusion: The treatment landscape in MM is complex and evolving. There is an unmet need for more effective therapies to reduce disease burden, particularly in tri-exposed patients.
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Affiliation(s)
| | | | | | - Emily Luke
- Adelphi Real World, Bollington, SK10 5JB, UK
| | | | | | | | | | - Francesa Gay
- Division of Hematology 1, Clinical trial unit AOU città della salute e della scienza, University of Torino, Torino, I-10125, Italy
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12
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Beer H, Chung H, Harrison SJ, Quach H, Krishnasamy M. Listening to what matters most: Consumer endorsed patient reported outcome measures (PROMs) for use in multiple myeloma clinical trials: a descriptive exploratory study. CLINICAL LYMPHOMA MYELOMA AND LEUKEMIA 2023:S2152-2650(23)00090-3. [PMID: 37087351 DOI: 10.1016/j.clml.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Patients with multiple myeloma (MM) experience some of the highest levels of symptom burden of all hematological malignancies. Therefore, assessment of quality of life (QoL) is critical for the delivery of patient-centered cancer care. Patient reported outcome measures (PROMs) are commonly used to measure QoL in people with MM. However, it is unknown whether measures used, are appropriate and informative to address issues that matter most to patients. AIM This exploratory study was designed to establish consumer endorsed PROMs to measure QoL in people with MM. METHOD This was a descriptive, exploratory study. Participants were invited to provide feedback on the acceptability, appropriateness, and practicability of ten commonly used PROMs via telephone-based, semi-structured interviews and surveys. Data were analyzed using a manifest content analysis approach and descriptive statistics. RESULTS 26 individuals participated in the study. Participants emphasized the importance of selecting a suite of PROMs that captures the diversity of quality-of-life experiences and priorities reported over the course of treatment, while minimizing the burden of completing PROMs. Based on these criteria, a suite of three PROMs - the MyPOS, the Brief Fatigue Inventory, and COST-FACIT were endorsed by study participants. CONCLUSION To our knowledge, this is the first study of its kind to establish a suite of consumer-endorsed PROMs for use in clinical trials in patients with MM. Ensuring that the patient voice is at the center of advances in cancer treatment is a hallmark of quality cancer care.
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13
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Kirkpatrick S, Campbell K, Harding S. A survey of quality-of-life tools used in the routine care of patients with multiple myeloma. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S10-S14. [PMID: 36913337 DOI: 10.12968/bjon.2023.32.5.s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND New treatment options have significantly improved the life expectancy of myeloma patients such that their cause of death is increasingly likely to be from something other than myeloma. Furthermore, the adverse effects of short- or long-term treatments as well as the disease are impacting on quality of life (QoL) for longer periods of time. Understanding people's QoL and what is important to them, is part of providing holistic care. Although QoL data has been collected for many years in myeloma studies, they have not been used to inform patient outcomes. There is growing evidence that supports the assessment of 'fitness' and consideration of QoL as part of routine myeloma care. A national survey was carried out to discover which QoL tools are currently being used in the routine care of myeloma patients, by whom and at which time point. METHODS An online survey using SurveyMonkey was adopted for flexibility and accessibility. The link to the survey was circulated via Bloodwise, Myeloma UK and Cancer Research UK contact lists. Paper questionnaires were circulated at the UK Myeloma Forum. RESULTS Data about practices in 26 centres were collected. This included sites across England and Wales. Three out of 26 centres collect QoL data as part of standard care. QoL tools used include EORTC QLQ-My20/24, MyPOS, FACT-BMT and Quality of Life Index. Questionnaires were completed by patients before, during or after a clinic appointment. Clinical nurse specialists calculate the scores and create a care plan. CONCLUSION Despite growing evidence to support an holistic approach to management of myeloma patients, there is a lack of evidence to confirm that health-related QoL is being addressed in standard care. This is an area that needs further research.
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Affiliation(s)
| | - Karen Campbell
- Associate Professor of Cancer Nursing, School of Health and Social Care, Edinburgh Napier University, Edinburgh
| | - Sam Harding
- Research Fellow, North Bristol NHS Trust, Bristol
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Cohen AD, Hari P, Htut M, Berdeja JG, Usmani SZ, Madduri D, Olyslager Y, Goldberg JD, Schecter JM, Jackson CC, Gries KS, Fastenau JM, Valluri S, Deraedt W, Akram M, Crawford R, Morrison R, Doward L, Morgan K, Seldam ST, Jakubowiak A, Jagannath S. Patient Perceptions Regarding Ciltacabtagene Autoleucel Treatment: Qualitative Evidence From Interviews With Patients With Relapsed/Refractory Multiple Myeloma in the CARTITUDE-1 Study. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:68-77. [PMID: 36357295 DOI: 10.1016/j.clml.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/26/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Ciltacabtagene autoleucel (cilta-cel), a novel chimeric antigen receptor T (CAR-T) cell therapy, has demonstrated early, deep, and durable clinical responses in heavily pretreated patients with relapsed/refractory multiple myeloma (RRMM), and improvements in health-related quality of life (HRQoL) in CARTITUDE-1 (NCT03548207). Patient perspectives on treatment provide context to efficacy outcomes and are an important aspect of therapeutic evaluation. METHODS Qualitative interviews were conducted in a subset of CARTITUDE-1 patients (n = 36) at screening, Day 100, and Day 184 post cilta-cel on living with MM, therapy expectations, and treatment experiences during the study. RESULTS Patients most wanted to see change in symptoms with the greatest impact on HRQoL: pain (85.2%) and fatigue (74.1%). The primary treatment expectation was achieving remission (40.7%), followed by extended life expectancy (14.8%). Patients most often defined meaningful change as improvement in symptoms (70.4%) and return to normalcy (40.7%). The percentage of patients reporting symptoms (pain, fatigue, bone fracture, gastrointestinal, neuropathy, and weakness) decreased from 85.2% to 22.2% across symptom types at baseline to 29.2% to 0% on Day 184 after cilta-cel. Improved symptoms and positive sentiments corresponded with improved perception of overall health status and reduced pain level, respectively. Most patients reported that their expectations of cilta-cel treatment had been met (70.8%) or exceeded (20.8%) at Day 184, and 70.8% of patients considered cilta-cel therapy better than their previous treatments. CONCLUSION Overall HRQoL improvements and qualitative interviews showed cilta-cel met patient expectations of treatment and suggest the long treatment-free period also contributed to positive sentiments.
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Affiliation(s)
- Adam D Cohen
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | | | - Myo Htut
- City of Hope Comprehensive Cancer Center, Duarte, CA
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Batioja K, Peña A, Smith C, Minley K, Wise A, Shepard S, Heigle B, Ottwell R, Hartwell M, Vassar M. Evaluating The Reporting of Patient-Reported Outcomes in Surgical Management of Stress Urinary Incontinence in Women: An Analysis of Randomized Controlled Trials. Womens Health Issues 2022; 33:312-319. [DOI: 10.1016/j.whi.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/15/2022] [Accepted: 10/21/2022] [Indexed: 11/26/2022]
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16
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Efficace F, Gaidano G, Petrucci MT, Niscola P, Cottone F, Codeluppi K, Antonioli E, Tafuri A, Larocca A, Potenza L, Fozza C, Pastore D, Rigolin GM, Offidani M, Romano A, Kyriakou C, Cascavilla N, Gozzetti A, Derudas D, Vignetti M, Cavo M. Association of IMWG frailty score with health-related quality of life profile of patients with relapsed refractory multiple myeloma in Italy and the UK: a GIMEMA, multicentre, cross-sectional study. THE LANCET. HEALTHY LONGEVITY 2022; 3:e628-e635. [PMID: 36102777 DOI: 10.1016/s2666-7568(22)00172-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The clinical management of patients with relapsed or refractory multiple myeloma is challenging and there is a paucity of tools to help clinicians make more informed decisions for the most suitable treatment options. We aimed to investigate the clinical utility of the International Myeloma Working Group (IMWG) frailty score in the setting of relapsed or refractory multiple myeloma, by examining its ability to capture different patient-reported health-related quality of life profiles. METHODS We did a cross-sectional analysis of a prospective observational study of patients with relapsed or refractory multiple myeloma in Italy and the UK (30 hospitals across northern, central, and southern Italy, and one hospital in London, UK). Inclusion criteria were age 18 years or older and patients who had received at least one previous line of therapy and no more than five lines. Participants were excluded if they had a psychiatric disorder or major cognitive dysfunction, or any grade 3 or higher adverse event within 2 weeks before study entry. On study initiation, physicians had to assess frailty according to the IMWG criteria, which included the Charlson Comorbidity Index, the Katz Activity of Daily Living, and the Lawton Instrumental Activities of Daily Living. Patients were asked to complete patient-reported outcome measures, including the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) and its validated multiple myeloma module (QLQ-MY20). A multivariable linear regression model was used to assess the mean differences in health-related quality of life scores between frailty groups to account for key potential confounding factors. FINDINGS Overall, between Nov 13, 2017, and Nov 15, 2021, 415 patients with relapsed or refractory multiple myeloma, with a median age of 69·8 years (IQR 62·8-75·2) were enrolled. The median time since diagnosis was 4·4 years (IQR 2·5-7·1) and most patients (351 [85%]) had received at least two previous lines of therapy. According to the IMWG frailty score, 200 (48%) were classified as fit, 112 (27%) were classified as intermediate-fit, and 103 (25%) patients were classified as frail. Each frailty group was associated with a distinct health-related quality of life profile, with most notable differences between fit and frail patients. The largest clinically meaningful adjusted differences between fit and frail patients by the EORTC QLQ-C30 questionnaire were observed for physical functioning (Δ=-19·0 [95% CI -25·6 to -12·5; p<0·0001), fatigue (Δ=16·7 [9·7 to 23·7]; p<0·0001), insomnia (Δ=13·4 [4·1 to 22·6]; p=0·0047), and dyspnoea (Δ=12·5 [4·6 to 20·4]; p=0·0021). The most prevalent clinically important symptom in the overall population was pain; however, its prevalence varied between IMWG frailty groups at 70·9% in frail patients, 55·9% in intermediate-fit patients, and 50·5% in fit patients. INTERPRETATION Our findings show the clinical utility of the IMWG frailty score in the setting of relapsed or refractory multiple myeloma, in helping to distinguish between groups of patients with distinct health-related quality of life profiles. Further research is needed to examine the value of patient-reported outcome data in improving assessment of frailty in the setting of relapsed or refractory multiple myeloma. FUNDING Fondazione GIMEMA Franco Mandelli Onlus and Amgen.
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Affiliation(s)
- Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy.
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Maria Teresa Petrucci
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | | | - Francesco Cottone
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Katia Codeluppi
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Alessandra Larocca
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Leonardo Potenza
- Hematology Unit, Azienda Ospedaliera Universitaria di Modena, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudio Fozza
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | - Gian Matteo Rigolin
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliera- Universitaria, Arcispedale S Anna, University of Ferrara, Ferrara, Italy
| | - Massimo Offidani
- Hematology Clinic, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Alessandra Romano
- Division of Hematology, Policlinico, Department of Surgery and Medical Specialties, University of Catania, Catania, Italy
| | | | - Nicola Cascavilla
- Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - Alessandro Gozzetti
- Hematology, University of Siena Policlinico S Maria alle Scotte, Siena, Italy
| | | | - Marco Vignetti
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Serà gnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
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Schoenbeck KL, Wildes TM. Refining frailty in relapsed or refractory multiple myeloma: adding the patient voice. THE LANCET. HEALTHY LONGEVITY 2022; 3:e579-e580. [PMID: 36102770 DOI: 10.1016/s2666-7568(22)00192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- Kelly L Schoenbeck
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Division of Hematology/Oncology, Department of Medicine, Veterans Affairs Medical Center, San Francisco, CA, USA.
| | - Tanya M Wildes
- Division of Hematology/Oncology, Department of Medicine, University of Nebraska Medical Center/Nebraska Medicine, Omaha, NE, USA
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Brock L, Hightower B, Moore T, Nees D, Heigle B, Shepard S, Kee M, Ottwell R, Hartwell M, Vassar M. Reporting of Patient-Reported Outcome Measures in Randomized Controlled Trials on Shoulder Rotator Cuff Injuries Is Suboptimal and Requires Standardization. Arthrosc Sports Med Rehabil 2022; 4:e1429-e1436. [PMID: 36033194 PMCID: PMC9402470 DOI: 10.1016/j.asmr.2022.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/25/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Methods Results Conclusions Clinical Relevance
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Affiliation(s)
- Lydia Brock
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
- Address correspondence to Lydia Brock, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107.
| | - Brooke Hightower
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
| | - Ty Moore
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
| | - Danya Nees
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
| | - Benjamin Heigle
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
| | - Samuel Shepard
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
| | - Micah Kee
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
- Department of Internal Medicine, University of Oklahoma, School of Community Medicine Tulsa, Oklahoma, U.S.A
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, U.S.A
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Efficace F, Cottone F, Sparano F, Caocci G, Vignetti M, Chakraborty R. Patient-Reported Outcomes in Randomized Controlled Trials of Patients with Multiple Myeloma: A Systematic Literature Review of Studies Published Between 2014 and 2021. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2022; 22:442-459. [PMID: 35183476 DOI: 10.1016/j.clml.2022.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND We performed a systematic literature review to identify the most recently published randomized controlled trials (RCTs) in multiple myeloma (MM) with a patient-reported outcome (PRO) endpoint, and to summarize both clinical and PRO results, as well as to examine the quality of reporting by phase of disease. We also aimed to describe main type of PRO analysis used and interpretation of clinical significance of PRO findings. MATERIALS AND METHODS We searched PubMed and the Cochrane Central Register of Controlled Trials to identify RCTs of cancer-directed therapy in patients with MM published between January 2014 and April 2021. RESULTS Thirty-two RCTs with a total of 19,798 patients enrolled were identified in our review. In all studies, PROs were secondary or exploratory endpoints. Half of the studies (n = 16) included newly diagnosed patients, 15 RCTs included patients with relapsed/refractory MM, and one study included patients with smoldering MM. Progression-free survival was the most frequently used primary endpoint. All studies provided unique PRO information that could be used to more comprehensively assess the risk/benefit of the newly tested drugs. However, the identified RCTs were heterogeneous regarding the presentation, and interpretation of PRO results. CONCLUSION The number of RCTs including PROs in MM research has notably increased in recent years. However, more consistency in the methodological approach to PRO assessment, and interpretation of outcomes is needed to ensure that PRO findings will be more impactful on patient care.
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Affiliation(s)
- Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy.
| | - Francesco Cottone
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Francesco Sparano
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Giovanni Caocci
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marco Vignetti
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Rajshekhar Chakraborty
- Division of Hematology and Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
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LeBlanc MR, Bryant AL, LeBlanc TW, Yang Q, Sellars E, Chase CC, Smith SK. A cross-sectional observational study of health-related quality of life in adults with multiple myeloma. Support Care Cancer 2022; 30:5239-5248. [PMID: 35262791 PMCID: PMC9050896 DOI: 10.1007/s00520-022-06943-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/26/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The purpose of this manuscript is to describe health-related quality of life (HRQoL) outcomes in a United States (US)-based sample of multiple myeloma (MM) patients and identify characteristics associated with poor HRQoL. PATIENTS AND METHODS MM patients identified through the Tumor Registry of a Southeastern US medical center were mailed surveys assessing patient characteristics and HRQoL outcomes. HRQoL outcomes were measured using PROMIS short form instruments which included measures of global health (global physical health and global mental health), physical function, and ability to participate in social roles and activities (social function). HRQoL domain scores were summarized, and best subset linear regression was used to identify predictors of HRQoL. RESULTS A total of 690 patients completed and returned surveys for a response rate of 64.7%. Respondents reported global physical health (44.9), global mental health (47.5), and physical function (44.1) significantly worse than the general population mean of 50 (p < .0001). Social function (49.5) did not differ significantly (p = .09). Worse socioeconomic status, higher comorbidities, not being in remission, and past receipt of radiation therapy were significantly associated with worse HRQoL. Treatment status and time since diagnosis were not associated with HRQoL outcomes. CONCLUSIONS Patients with MM have significantly worse HRQoL than the general population. These findings warrant increased attention from clinicians and researchers. More research is needed to better describe the relationship between treatment patterns and HRQoL in patients with MM, and to identify effective interventions.
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Affiliation(s)
- Matthew R. LeBlanc
- University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center
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21
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Lyall M, Crawford R, Bell T, Mamolo C, Neuhof A, Levy C, Heyes A. Characterizing the Patient Journey in Multiple Myeloma: A Patient Perspective (Preprint). JMIR Cancer 2022; 8:e39068. [PMID: 36136395 PMCID: PMC9539647 DOI: 10.2196/39068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background The patient experience of multiple myeloma (MM) is multifaceted and varies substantially between individuals. Current published information on the patient perspective and treatment of MM is limited, making it difficult to gain insights into patient needs regarding the condition. Objective In this review, a combined research method approach (ie, the review of published literature and social media posts) was undertaken to provide insight into patients’ perspectives on the burden and treatment of MM, the impact of the COVID-19 pandemic, and the impact of MM on caregivers of patients with MM. Methods Targeted searches of PubMed and PsycINFO were conducted from November 16, 2010, to November 16, 2020; in parallel, patient-reported information derived from social media posts from 6 patient advocacy websites and YouTube were searched. The review of patient advocacy websites and YouTube targeted patient-reported information from patients with a self-reported diagnosis of MM who discussed their experience of MM and its treatments. Results A total of 27 articles and 138 posts were included (patient-reported information included data from 76 individuals), and results from both sources showed that patients experienced a variety of symptoms and treatment side effects, including neuropathy, fatigue, nausea, and back pain. These can affect areas of health-related quality of life (HRQOL), including physical functioning; emotional, psychological, and social well-being; the ability to work; and relationships. Patients valued involvement in treatment decision-making, and both the patient-reported information and the literature indicated that efficacy and tolerability strongly influence treatment decision-making. For patients, caregivers, and physicians, the preference for treatments was strongest when associated with increased survival. Caregivers can struggle to balance care responsibilities and jobs, and their HRQOL is affected in several areas, including emotional-, role-, social-, and work-related aspects of life. The COVID-19 pandemic has challenged patients’ ability to manage MM because of limited hospital access and restrictions that negatively affected their lives, psychological well-being, and HRQOL. Unmet patient needs identified in the literature and patient-reported information were for more productive appointments with health care professionals, better-tolerated therapies, and more support for themselves and their caregivers. Conclusions The combination of published literature and patient-reported information provides valuable and rich details on patient experiences and perceptions of MM and its treatment. The data highlighted that patients’ HRQOL is impeded not only by the disease but also by treatment-related side effects. Patients in the literature and patient-reported information showed a strong preference for treatments that prolong life, and patients appeared to value participation in treatment decisions. However, there remain unmet needs and areas for further research, including treatment, caregiver burden, and how to conduct appointments with health care professionals. This may help improve the understanding of the journey of patients with MM. Plain Language Summary Multiple Myeloma (MM) is the second most common cancer that affects blood cells. In this study, researchers wanted to know patients’ views on the effects of MM and the treatments they received. Researchers also looked at the impact of the COVID-19 pandemic on patients’ treatment and the impact of MM on caregivers. To this end, the researchers reviewed information from 27 published studies and 138 social media posts by 76 patients with MM. Patients commonly reported nerve pain, tiredness, feeling sick, and back pain caused by MM and the treatments they received. The effects of MM and treatments affected patients’ physical function; emotional, psychological, and social well-being; ability to work; and relationships. The researchers found that patients wanted to be involved in decisions related to their treatment. The effectiveness against MM and known negative effects strongly influenced the choice of treatments for patients. Increased survival was the strongest factor in the choice of treatment for patients, caregivers, and doctors. Researchers found that the emotional-, role-, social-, and work-related aspects of caregivers’ lives were affected by caring for patients with MM. The COVID-19 pandemic also affected the ability of patients to manage their MM because of limited hospital access and the effects of restrictions that impacted their lives and psychological well-being. Finally, the researchers identified some areas requiring improvement, including unproductive appointments with health care professionals, the need for treatments with fewer negative effects, and more support for patients with MM and their caregivers. This information may be useful to improve and understand the experience of patients with MM.
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Affiliation(s)
| | | | - Timothy Bell
- SpringWorks Therapeutics, Stamford, CT, United States
| | | | | | | | - Anne Heyes
- RTI Health Solutions, Manchester, United Kingdom
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22
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Terpos E, Dimopoulos MA, Boccadoro M, Delimpasi S, Beksac M, Katodritou E, Moreau P, Pompa A, Symeonidis A, Bila J, Oriol A, Mateos M, Einsele H, Orfanidis I, Gries KS, Fastenau J, Liu K, He J, Kampfenkel T, Qiu Y, Amin H, Carson R, Sonneveld P. Health-related quality of life in patients with relapsed/refractory multiple myeloma treated with pomalidomide and dexamethasone ± subcutaneous daratumumab: Patient-reported outcomes from the APOLLO trial. Am J Hematol 2022; 97:481-490. [PMID: 35089607 DOI: 10.1002/ajh.26480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/06/2022] [Accepted: 01/24/2022] [Indexed: 11/12/2022]
Abstract
In the phase 3 APOLLO trial, daratumumab in combination with pomalidomide and dexamethasone (D-Pd) significantly reduced the rate of disease progression or death by 37% relative to Pd alone in patients with relapsed/refractory multiple myeloma (RRMM) who had received ≥1 prior line of therapy including lenalidomide and a proteasome inhibitor. Here, we present patient-reported outcomes (PROs) from APOLLO. Median treatment duration was 11.5 months with D-Pd and 6.6 months with Pd. PRO compliance rates were high and similar in both groups. No changes from baseline were observed for EORTC QLQ-C30 global health status scores in either group, while physical and emotional functioning, disease symptoms, and adverse effects of treatment remained at baseline levels with D-Pd but worsened with Pd. Reductions (p < 0.05) in pain and fatigue were seen at several time points with D-Pd versus Pd. Overall, these results suggest patients' health-related quality of life remained stable when daratumumab was added to Pd, with several results favoring D-Pd versus Pd. These findings complement the significant clinical improvements observed with D-Pd and support its use in patients with RRMM.
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Affiliation(s)
- Evangelos Terpos
- Department of Clinical Therapeutics National and Kapodistrian University of Athens Athens Greece
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics National and Kapodistrian University of Athens Athens Greece
| | - Mario Boccadoro
- Department of Molecular Biotechnology and Health Sciences University of Torino Turin Italy
| | | | - Meral Beksac
- Department of Hematology Ankara University Ankara Turkey
| | - Eirini Katodritou
- Department of Hematology Theagenio Cancer Hospital Thessaloniki Greece
| | - Philippe Moreau
- Hematology Department University Hospital Hôtel‐Dieu Nantes France
| | | | | | - Jelena Bila
- Clinic of Hematology University of Belgrade Belgrade Serbia
| | - Albert Oriol
- Institut Català d'Oncologia Hospital Germans Trias I Pujol Barcelona Spain
| | - Maria‐Victoria Mateos
- Hematology Department University Hospital of Salamanca/IBSAL/Cancer Research Center‐IBMCC (USAL‐CSIC) Salamanca Spain
| | - Hermann Einsele
- Department of Internal Medicine II University Hospital Würzburg Würzburg Germany
| | | | | | - John Fastenau
- Janssen Research & Development LLC Raritan New Jersey USA
| | - Kevin Liu
- Janssen Research & Development LLC Raritan New Jersey USA
| | - Jianming He
- Janssen Research & Development LLC Raritan New Jersey USA
| | | | - Yanping Qiu
- Janssen Research & Development LLC Beijing China
| | - Himal Amin
- Janssen Research & Development LLC Raritan New Jersey USA
| | - Robin Carson
- Janssen Research & Development LLC Wayne Pennsylvania USA
| | - Pieter Sonneveld
- Department of Hematology Erasmus University Medical Center Cancer Institute Rotterdam Netherlands
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23
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Mercieca-Bebber R, Aiyegbusi OL, King MT, Brundage M, Snyder C, Calvert M. Knowledge translation concerns for the CONSORT-PRO extension reporting guidance: a review of reviews. Qual Life Res 2022; 31:2939-2957. [PMID: 35347521 PMCID: PMC9470606 DOI: 10.1007/s11136-022-03119-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 10/29/2022]
Abstract
This review of reviews aimed to appraise the use of the CONSORT-PRO Extension as an evaluation tool for assessing the reporting of patient-reported outcome (PROs) in publications, and to describe the reporting of PRO research across reviews. We also outlined how variation in such evaluations impacts knowledge translation and may lead to potential misuse of the CONSORT-PRO Extension. We systematically searched Medline, Pubmed and CINAHL from 2013 to 2025 March 2021 for reviews of the completeness of reporting of PRO endpoints according to CONSORT-PRO criteria. Two reviewers extracted details of each review, the percentage of included studies that addressed each CONSORT-PRO item, and key recommendations from each review. Fourteen reviews met inclusion criteria, and only six of these used the full CONSORT-PRO checklist with minimal justified modifications. The remaining eight studies made significant or unjustified adjustments to the CONSORT-PRO Extension. Review studies also varied in how they scored multi-component CONSORT-PRO items. CONSORT-PRO items were often unreported in trial reports, and certain CONSORT-PRO items were reported less often than others. The reporting of statistical approaches to dealing with missing PRO data were poor in RCTs included in all 14 review articles. Studies reviewing PRO publications often omitted recommended CONSORT-PRO items from their evaluations, which may cause confusion among readers regarding how best to report their PRO research according to the CONSORT-PRO extension. Many trials published since CONSORT-PRO's release did not report recommended CONSORT-PRO items, which may lead to misinterpretation and consequently to research waste.
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Affiliation(s)
- Rebecca Mercieca-Bebber
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research, and Birmingham Health Partners Centre for Regulatory Science and Innovation, Institute of Applied Health Research, University of Birmingham, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Research Centre, NIHR Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
| | - Madeleine T King
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - Michael Brundage
- Cancer Care and Epidemiology, Department of Oncology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Claire Snyder
- Johns Hopkins School of Medicine and Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research, and Birmingham Health Partners Centre for Regulatory Science and Innovation, Institute of Applied Health Research, University of Birmingham, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
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24
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Larocca A, Leleu X, Touzeau C, Bladé J, Paner A, Mateos M, Cavo M, Maisel C, Alegre A, Oriol A, Raptis A, Rodriguez‐Otero P, Mazumder A, Laubach J, Nadeem O, Sandberg A, Orre M, Torrång A, Bakker NA, Richardson PG. Patient-reported outcomes in relapsed/refractory multiple myeloma treated with melflufen plus dexamethasone: analyses from the Phase II HORIZON study. Br J Haematol 2022; 196:639-648. [PMID: 34671975 PMCID: PMC9135124 DOI: 10.1111/bjh.17887] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 12/04/2022]
Abstract
Relapsed/refractory multiple myeloma (RRMM) is known to have a high burden of disease and complications associated with refractoriness to prior lines of therapy. Severe pain and fatigue symptoms and impairments in physical and emotional functioning have been strongly linked to reduced health-related quality of life (HRQoL) in patients with RRMM. Assessment of patient reported-outcome measures from the pivotal, Phase II HORIZON study (OP-106; NCT02963493) in patients with RRMM (n = 64) demonstrated that melphalan flufenamide (melflufen) plus dexamethasone treatment preserved HRQoL. Patients had clinically meaningful improvements, even after eight treatment cycles, in relevant scales such as global health status/QoL, physical functioning, emotional functioning, pain, and fatigue. Patients with triple-class-refractory disease (n = 50) displayed similar improvements. Patient-reported outcome deterioration was delayed for a substantial amount of time in patients who experienced a response to melflufen plus dexamethasone treatment relative to patients who did not experience a response. These findings support the notion that treatment with melflufen plus dexamethasone may sustain or improve HRQoL over time in patients with RRMM, including in patients with triple-class-refractory disease for whom outcomes are generally worse. The clinical benefits observed in patients from the HORIZON trial are encouraging and supportive of translation into real-world practice.
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Affiliation(s)
- Alessandra Larocca
- Myeloma UnitDivision of HematologyUniversity of TorinoAzienda Ospedaliero – Universitaria Città della Salute e della ScienzaTurinItaly
| | | | - Cyrille Touzeau
- Centre de Recherche en Cancérologie et Immunologie Nantes‐Angers (CRCINA)Institut National de la Santé et de la Recherche Médicale (INSERM)Centre National de la Recherche Scientifique (CNRS)Université d’AngersUniversité de NantesNantesFrance
- Site de Recherche Intégrée sur le Cancer (SIRIC), Imaging and Longitudinal Investigations to Ameliorate Decision‐making (ILIAD)NantesFrance
- Service d’Hématologie CliniqueCentre Hospitalier UniversitairePlace Alexis RicordeauNantesFrance
| | - Joan Bladé
- Hematology DepartmentIDIBAPS, Hospital ClinicBarcelonaSpain
| | - Agne Paner
- Rush University Medical CenterChicagoILUSA
| | | | - Michele Cavo
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaSeràgnoli Institute of HematologyBologna University School of MedicineBolognaItaly
| | | | - Adrían Alegre
- Hospital Universitario La Princesa and Hospital Universitario QuironsaludMadridSpain
| | - Albert Oriol
- Institut Català d’Oncologia and Josep Carreras Research InstituteHospital Germans Trias i PujolBadalonaSpain
| | - Anastasios Raptis
- Division of Hematology‐OncologyDepartment of MedicineUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | | | | | - Jacob Laubach
- Dana‐Farber Cancer InstituteHarvard Medical SchoolBostonMAUSA
| | - Omar Nadeem
- Dana‐Farber Cancer InstituteHarvard Medical SchoolBostonMAUSA
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25
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Jensen CE, Vohra SN, Nyrop KA, Deal AM, LeBlanc MR, Grant SJ, Muss HB, Lichtman EI, Rubinstein SM, Wood WA, Mangieri NJ, Jamison L, Tuchman SA. OUP accepted manuscript. Oncologist 2022; 27:694-702. [PMID: 35511734 PMCID: PMC9355823 DOI: 10.1093/oncolo/oyac079] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/22/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Christopher E Jensen
- Corresponding author: Christopher E. Jensen, MD, 170 Manning Drive, Houpt Building, CB# 7305, 3rd Floor, Chapel Hill, NC 27599, USA. Tel: +1 252 908 1739; Fax: +1 919 966 6735;
| | - Sanah N Vohra
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthew R LeBlanc
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shakira J Grant
- Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eben I Lichtman
- Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Samuel M Rubinstein
- Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - William A Wood
- Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nicholas J Mangieri
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lee Jamison
- Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sascha A Tuchman
- Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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26
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Dechow T, Aldaoud A, Behlendorf T, Knauf W, Eschenburg H, Groschek M, Hansen R, Söling U, Grebhardt S, Siebenbach HU, Vannier C, Potthoff K. Pomalidomide plus dexamethasone for patients with relapsed or refractory multiple myeloma: Final results of the non-interventional study POSEIDON and comparison with the pivotal phase 3 clinical trials. Eur J Haematol 2021; 108:133-144. [PMID: 34714555 PMCID: PMC9298817 DOI: 10.1111/ejh.13719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022]
Abstract
Background Prognosis of patients with multiple myeloma (MM) who have relapsed on or become refractory to immunomodulators and bortezomib is poor, and treatment options are limited. While pomalidomide plus low‐dose dexamethasone (POM/DEX) has demonstrated efficacy in clinical trials, real‐world evidence is scarce. Patients and Methods POSEIDON was a prospective non‐interventional study designed to evaluate effectiveness, safety and quality of life (QoL) of POM/DEX in patients with relapsed or refractory MM (R/RMM) pretreated with at least two prior therapy lines including both lenalidomide and bortezomib in real world in Germany. Patients received POM/DEX according to physicians’ choice. Data were analyzed descriptively. Results Between 2014 and 2017, 151 patients were enrolled, 144 patients with a median of three prior therapy lines qualified for effectiveness analysis. Median age was 73.2 years. Median progression‐free and overall survival were 6.3 months [95% confidence interval (CI) 5.2, 8.6] and 12.9 months [95% CI 10.6, 15.1]. Most frequent grade 3/4 adverse events were leukopenia (8.2%), pneumonia (7.5%) and anemia (5.5%). QoL was maintained after start of POM/DEX. Conclusion The results of POSEIDON support the effectiveness and safety of POM/DEX in R/RMM patients pretreated with lenalidomide and bortezomib and highlight the clinical value of the POM/DEX regimen in the real‐world setting. Registered at clinicaltrials.gov (NCT02075996).
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Affiliation(s)
| | - Ali Aldaoud
- Gemeinschaftspraxis für Hämatologie & Onkologie, Leipzig, Germany
| | - Timo Behlendorf
- Gemeinschaftspraxis für Innere Medizin, Hämatologie & Onkologie, Halle (Saale), Germany
| | - Wolfgang Knauf
- Centrum für Hämatologie und Onkologie Bethanien, Frankfurt am Main, Germany
| | | | | | - Richard Hansen
- Schwerpunktpraxis für Hämatologie und Onkologie, Kaiserlautern, Germany
| | - Ulrike Söling
- Hämato-onkologisches Zentrum Kassel GmbH, Kassel, Germany
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27
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Plesner T, Dimopoulos MA, Oriol A, San-Miguel J, Bahlis NJ, Rabin N, Suzuki K, Yoon SS, Ben-Yehuda D, Cook G, Goldschmidt H, Grosicki S, Qin X, Fastenau J, Garvin W, Carson R, Renaud T, Gries KS. Health-related quality of life in patients with relapsed or refractory multiple myeloma: treatment with daratumumab, lenalidomide, and dexamethasone in the phase 3 POLLUX trial. Br J Haematol 2021; 194:132-139. [PMID: 33822368 DOI: 10.1111/bjh.17435] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/04/2021] [Indexed: 11/30/2022]
Abstract
In the phase 3 POLLUX trial, daratumumab in combination with lenalidomide and dexamethasone (D-Rd) significantly improved progression-free survival in patients with relapsed/refractory multiple myeloma (RRMM) compared with lenalidomide and dexamethasone (Rd) alone. Here, we present patient-reported outcomes (PROs) from POLLUX, assessed using the validated European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item (EORTC QLQ-C30) and the EuroQol 5-dimensional descriptive system (EQ-5D-5L) questionnaires. Changes from baseline are presented as least-squares mean changes with 95% confidence intervals (CIs) derived from a mixed-effects model. PRO assessment compliance rates were high and similar in both D-Rd and Rd groups through cycle 40 (week 156). In this on-treatment analysis, mean changes from baseline were significantly greater in EORTC QLQ-C30 global health status, physical functioning, and pain scores in the D-Rd group versus the Rd group at multiple time points; however, magnitude of changes was low, suggesting no meaningful impact on health-related quality of life (HRQoL). Subgroup results were similar to those in the overall population. In the POLLUX study, baseline HRQoL was maintained with prolonged D-Rd treatment. These findings complement the sustained and significant improvement in progression-free survival observed with D-Rd and supports its use in patients with RRMM. Clinical trial registration: NCT02076009.
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Affiliation(s)
- Torben Plesner
- Vejle Hospital and University of Southern Denmark, Vejle, Denmark
| | | | - Albert Oriol
- Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Barcelona, Spain
| | | | | | - Neil Rabin
- Department of Haematology, University College London Hospitals NHS Trust, London, UK
| | - Kenshi Suzuki
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Dina Ben-Yehuda
- Hematology Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Hartmut Goldschmidt
- Internal Medicine V, University Hospital Heidelberg and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | | | - Xiang Qin
- Janssen Research & Development, Spring House, PA, USA
| | | | - Wendy Garvin
- Janssen Research & Development, Spring House, PA, USA
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Electronic Patient-Reported Outcome Measures Evaluating Cancer Symptoms: A Systematic Review. Semin Oncol Nurs 2021; 37:151145. [PMID: 33773879 DOI: 10.1016/j.soncn.2021.151145] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 11/30/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This systematic review aims to evaluate the psychometric properties and the methodologic quality of studies describing smartphone-, tablet- or computer-based questionnaires for Patient-Reported Outcome Measures (PROM) evaluating symptoms in oncology and hematology patients. DATA SOURCES A literature search was conducted in PubMed, Scopus, Cochrane, Cinahl, Cuiden, Lilacs, and PsycINFO. Criteria for inclusion were (i) primary studies evaluating scales for symptoms assessment, (ii) developed in adult population (>18 years) with an oncology or hematology malignancy diagnosis, (iii) validations tested via phone or computer, and (iv) describing at least one psychometric property. The exclusion criteria were (i) tools diagnosing any type of cancer and (ii) case series, surveys, and audits. The outcome variables were internal consistency, test-retest reliability, measurement error, content validity, structural validity, hypothesis testing, cross-cultural validity, and responsiveness. For the evaluation of the quality of methodology, the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used. CONCLUSION The present study gathered five tools in 12 articles to evaluate cancer symptoms through smartphone, tablet, or computer format. Although four were generic, one was specific for breast cancer. Although none of the tools had been fully validated, some of the items of the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) were successfully tested for content, reliability, construct validity, and responsiveness. IMPLICATIONS FOR NURSING PRACTICE Our results can guide professionals choosing symptoms assessment instruments when performing telepractice, and they raise awareness of using with precaution scales not intended for remote use.
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29
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LeBlanc MR, LeBlanc TW, Leak Bryant A, Pollak KI, Bailey DE, Smith SK. A Qualitative Study of the Experiences of Living With Multiple Myeloma. Oncol Nurs Forum 2021; 48:151-160. [PMID: 33600390 DOI: 10.1188/21.onf.151-160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the ways in which multiple myeloma affects an individual's life in the modern treatment era. PARTICIPANTS & SETTING 15 individuals with multiple myeloma and 10 clinicians were recruited from two academic medical centers in the southeastern United States. METHODOLOGIC APPROACH Semistructured interviews were conducted with individuals with multiple myeloma and clinicians to explore the effect of a multiple myeloma diagnosis and treatment on individuals' lives. Transcribed interviews were analyzed using conventional content analysis. FINDINGS The following four themes emerged from the analysis. IMPLICATIONS FOR NURSING The treatment journey for those with multiple myeloma can be lifelong and may require frequent visits to an oncologist and, potentially, many successive lines of therapy. Life effects are far-reaching and long-term. Nurses should be aware of the interprofessional resources to help meet these individuals' needs. With thorough assessment, care planning, and education, nurses can play a key role in mitigating the negative effects of multiple myeloma and its treatment.
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Hungria V, Beksac M, Weisel KC, Nooka AK, Masszi T, Spicka I, Munder M, Mateos MV, Mark TM, Qi M, Qin X, Fastenau J, Spencer A, Sonneveld P, Garvin W, Renaud T, Gries KS. Health-related quality of life maintained over time in patients with relapsed or refractory multiple myeloma treated with daratumumab in combination with bortezomib and dexamethasone: results from the phase III CASTOR trial. Br J Haematol 2021; 193:561-569. [PMID: 33555030 DOI: 10.1111/bjh.17321] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/21/2020] [Indexed: 11/26/2022]
Abstract
In the phase III CASTOR trial, daratumumab, bortezomib and dexamethasone (D-Vd) significantly extended progression-free survival compared with bortezomib and dexamethasone (Vd) alone in patients with relapsed/refractory multiple myeloma (RRMM). Here, we present patient-reported outcomes (PROs) from the CASTOR trial. PROs were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item (EORTC QLQ-C30) and the EuroQol 5-dimensional descriptive system questionnaire. Treatment effects through Cycle 8 were measured by a repeated measures mixed-effects model. After Cycle 8, PROs were only collected for patients in the D-Vd group who continued on daratumumab monotherapy. Compliance rates for PRO assessments were high and similar between treatment groups. Mean changes from baseline were generally similar between treatment groups for EORTC QLQ-C30 global health status (GHS), functioning and symptoms, and did not exceed 10 points for either treatment group. Subgroup analyses were consistent with the results observed in the overall population. There was no change in patients' health-related quality of life for the first eight cycles of therapy; thereafter, patients treated with daratumumab over the long-term reported improvements in GHS and pain. These results complement the significant clinical benefits observed with D-Vd in patients with RRMM and support its use in this patient population.
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Affiliation(s)
| | | | - Katja C Weisel
- University Medical Center of Hamburg-Eppendorf, Hamburg, Germany
| | - Ajay K Nooka
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | | | - Ivan Spicka
- Charles University and General Hospital, Prague, Czech Republic
| | - Markus Munder
- Third Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | | | - Tomer M Mark
- University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Ming Qi
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Xiang Qin
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - John Fastenau
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | - Andrew Spencer
- Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, Australia
| | | | - Wendy Garvin
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Thomas Renaud
- Janssen Research & Development, LLC, Raritan, NJ, USA
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