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Moreau P, Chari A, Oriol A, Martinez-Lopez J, Haenel M, Touzeau C, Ailawadhi S, Besemer B, de la Rubia Comos J, Encinas C, Mateos MV, Salwender H, Rodriguez-Otero P, Hulin C, Karlin L, Sureda Balari A, Bargay J, Benboubker L, Rosiñol L, Tarantolo S, Terebelo H, Yang S, Wang J, Nnane I, Qi M, Kosh M, Delioukina M, Goldschmidt H. Daratumumab, carfilzomib, and dexamethasone in relapsed or refractory myeloma: final analysis of PLEIADES and EQUULEUS. Blood Cancer J 2023; 13:33. [PMID: 36882409 PMCID: PMC9989580 DOI: 10.1038/s41408-023-00805-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Affiliation(s)
| | - Ajai Chari
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Albert Oriol
- Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Joaquin Martinez-Lopez
- Hospital 12 de Octubre, H12O-CNIO, Haematological Malignancies Clinical Research Unit, Universidad Complutense, CIBERONC, Madrid, Spain
| | | | | | | | - Britta Besemer
- Universitaetsklinikum Tuebingen der Eberhard-Karls-Universitaet, Abteilung fuer Innere Medizin II, Tübingen, Germany
| | - Javier de la Rubia Comos
- Hospital La Fe, School of Medicine and Dentistry, Catholic University of Valencia, Valencia, Spain
- CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Cristina Encinas
- Hospital General Universitario Gregorio Marañón (HGUGM), IiSGM, Madrid, Spain
| | - Maria-Victoria Mateos
- University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Hans Salwender
- Asklepios Tumorzentrum Hamburg, AK Altona and AK St. Georg, Hamburg, Germany
| | | | - Cyrille Hulin
- Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac, France
| | - Lionel Karlin
- Department of Hematology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Anna Sureda Balari
- Hematology Department, Institut Català d'Oncologia - Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain
| | - Joan Bargay
- Hospital Universitari Son Llàtzer, IdISBa, Palma de Mallorca, Illes Balears, Spain
| | - Lotfi Benboubker
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire (CHRU), Tours, France
| | - Laura Rosiñol
- Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | | | | | - Shiyi Yang
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Jianping Wang
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Ivo Nnane
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Ming Qi
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Michele Kosh
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | - Hartmut Goldschmidt
- GMMG-Study Group at University Hospital Heidelberg, Internal Medicine V, Heidelberg, Germany
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Fonseca R, Tran D, Laidlaw A, Rosta E, Rai M, Duran J, Ammann EM. Impact of Disease Progression, Line of Therapy, and Response on Health-Related Quality of Life in Multiple Myeloma: A Systematic Literature Review. CLINICAL LYMPHOMA MYELOMA AND LEUKEMIA 2023; 23:426-437.e11. [PMID: 37061416 DOI: 10.1016/j.clml.2023.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
This systematic literature review (SLR) was conducted to better understand the impact of disease progression, line of therapy, and clinical response on health-related quality of life (HRQoL) in patients with multiple myeloma (MM). Multiple databases were searched to identify records relating to HRQoL in adult patients with MM. Titles and abstracts were independently screened by 2 reviewers for inclusion based on pre-defined criteria. Records flagged for inclusion had full texts subsequently screened using the same method. A third round of screening was then conducted to identify studies that assessed the relationship of HRQoL to disease progression, line of therapy, or clinical response. Quality assessment was conducted on utility studies using the National Institute for Health and Care Excellence Quality Assessment Checklist for Health State Utility Values. After all rounds of screening were complete, 44 records (representing 41 studies) were included in the SLR. Thirty records reported data relating HRQoL to disease progression, 5 reported data relating HRQoL to line of therapy, and 19 reported data relating HRQoL to response. Despite a lack of homogeneity and small number of studies, the data show overall that progressive disease and increasing lines of therapy were associated with worsened patient HRQoL and increasing depth of response was associated with improved patient HRQoL. The findings from this SLR support that desirable treatment outcomes such as delayed progression, fewer lines of therapy, and achieving the deepest possible clinical response result in improved HRQoL in patients with MM.
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Affiliation(s)
| | - Diana Tran
- EVERSANA(TM), Burlington, Ontario, Canada
| | | | | | - Manvir Rai
- EVERSANA(TM), Burlington, Ontario, Canada
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Seefat MR, Cucchi DGJ, Dirven S, Groen K, Zweegman S, Blommestein HM. A Systematic Review of Cost-Effectiveness Analyses of Novel Agents in the Treatment of Multiple Myeloma. Cancers (Basel) 2021; 13:cancers13225606. [PMID: 34830761 PMCID: PMC8615675 DOI: 10.3390/cancers13225606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary New treatments in multiple myeloma are embraced by patients and physicians but are also associated with substantial higher costs. To ensure the affordability and accessibility of health care, an evaluation of the outcomes in relation to the costs is increasingly requested. However, an up-to-date summary and assessment of the cost-effectiveness evidence for multiple myeloma treatments is currently lacking. We identified the cost-effectiveness studies currently available and show that novel treatments could improve survival with almost 4 years compared to standard of care. However, additional costs compared to standard of care could increase up to USD 535,530 per patient. The ratio between outcomes and costs is above currently accepted willingness to pay thresholds. Our results show cost-effectiveness ratios should be either improved or less favorable ratios should be accepted to ensure accessibility to promising treatments. Abstract Background: Novel therapies for multiple myeloma (MM) promise to improve outcomes but are also associated with substantial increasing costs. Evidence regarding cost-effectiveness of novel treatments is necessary, but a comprehensive up-to-date overview of the cost-effectiveness evidence of novel treatments is currently lacking. Methods: We searched Embase, Medline via Ovid, Web of Science and EconLIT ProQuest to identify all cost-effectiveness evaluations of novel pharmacological treatment of MM reporting cost per quality-adjusted life year (QALY) and cost per life year (LY) gained since 2005. Quality and completeness of reporting was assessed using the Consolidated Health Economic Evaluation Reporting Standards. Results: We identified 13 economic evaluations, comprising 32 comparisons. Our results show that novel agents generate additional LYs (range: 0.311–3.85) and QALYs (range: 0.1–2.85) compared to backbone regimens and 0.02 to 1.10 LYs and 0.01 to 0.91 QALYs for comparisons between regimens containing two novel agents. Lifetime healthcare costs ranged from USD 60,413 to 1,434,937 per patient. The cost-effectiveness ratios per QALY gained ranged from dominating to USD 1,369,062 for novel agents compared with backbone therapies and from dominating to USD 618,018 for comparisons between novel agents. Conclusions: Cost-effectiveness ratios of novel agents were generally above current willingness-to-pay thresholds. To ensure access, cost-effectiveness should be improved or cost-effectiveness ratios above current thresholds should be accepted.
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Affiliation(s)
- Maarten R. Seefat
- Department of Hematology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.G.J.C.); (S.D.); (K.G.); (S.Z.)
- Correspondence:
| | - David G. J. Cucchi
- Department of Hematology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.G.J.C.); (S.D.); (K.G.); (S.Z.)
| | - Stijn Dirven
- Department of Hematology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.G.J.C.); (S.D.); (K.G.); (S.Z.)
| | - Kaz Groen
- Department of Hematology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.G.J.C.); (S.D.); (K.G.); (S.Z.)
| | - Sonja Zweegman
- Department of Hematology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.G.J.C.); (S.D.); (K.G.); (S.Z.)
| | - Hedwig M. Blommestein
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands;
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Leleu X, Beksac M, Chou T, Dimopoulos M, Yoon SS, Prince HM, Pour L, Shelekhova T, Chari A, Khurana M, Zhang J, Obreja M, Qi M, Oriol A, Siegel D. Efficacy and safety of weekly carfilzomib (70 mg/m 2), dexamethasone, and daratumumab (KdD70) is comparable to twice-weekly KdD56 while being a more convenient dosing option: a cross-study comparison of the CANDOR and EQUULEUS studies. Leuk Lymphoma 2020; 62:358-367. [PMID: 33112184 DOI: 10.1080/10428194.2020.1832672] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The regimen of carfilzomib, daratumumab, and dexamethasone (KdD) shows activity in patients with relapsed/refractory multiple myeloma. KdD at the twice-weekly 56 mg/m2 carfilzomib dose (KdD56) was used in the randomized phase 3 CANDOR study (NCT03158688), whereas KdD at the once-weekly 70 mg/m2 carfilzomib dose (KdD70) was used in the phase 1 b EQUULEUS study (NCT01998971). We analyzed efficacy data from comparable CANDOR and EQUULEUS patients using inverse probability of treatment weighting (IPTW)-adjusted models. These weights were calculated from propensity scores derived to balance prespecified baseline covariates. The side-by-side and adjusted comparisons showed similar efficacy for overall response rates and progression-free survival in the two groups, with a series of sensitivity analyses showing consistent findings. Safety data were generally consistent with the known safety profiles of each individual drug. Once-weekly KdD70 is comparable to twice-weekly KdD56 in terms of efficacy and safety while being a more convenient dosing option.
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Affiliation(s)
- Xavier Leleu
- Service d'Hématologie et Thérapie cellulaire, CHU and Inserm, Poitiers, France
| | - Meral Beksac
- Department of Hematology, Ankara University, Ankara, Turkey
| | - Takaaki Chou
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Meletios Dimopoulos
- Hematology and Medical Oncology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - H Miles Prince
- Epworth Healthcare and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Ludek Pour
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | | | - Ajai Chari
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Monica Khurana
- Clinical Development, Oncology, Amgen Inc., Thousand Oaks, CA, USA
| | - Jianqi Zhang
- Global Biostatistical Science, Amgen Inc., Thousand Oaks, CA, USA
| | - Mihaela Obreja
- Global Biostatistical Science, Amgen Inc., Thousand Oaks, CA, USA
| | - Ming Qi
- Hematology and Oncology, Janssen Research and Development, LLC, Spring House, PA, USA
| | - Albert Oriol
- Institut Català d'Oncologia and Josep Carreras Research Leukaemia Institute, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - David Siegel
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
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