Elotuzumab May Improve Outcomes Without Negatively Impacting HRQoL in Multiple Myeloma

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Previous studies showed that elotuzumab plus lenalidomide and dexamethasone improved progression-free survival and response rates, but its impact on patient-reported outcomes is unknown.
Previous studies showed that elotuzumab plus lenalidomide and dexamethasone improved progression-free survival and response rates, but its impact on patient-reported outcomes is unknown.

Improvements in progression-free survival (PFS) and overall response rate (ORR) related to treatment with elotuzumab are possible without significant negative impact to health-related quality of life (HRQoL) among patients with relapsed/refractory multiple myeloma (RRMM), according to a study published in the Annals of Hematology.1

Results from the ELOQUENT-2 phase 3 (ClinicalTrials.gov Identifier: NCT01239797) study showed that elotuzumab plus lenalidomide and dexamethasone (ELd) improved PFS and response rates compared with Ld alone, but its impact on QoL and other clinical measures such as pain — a frequent symptom of MM — is unknown.

For this study, researchers assessed the patient-reported outcome (PRO) measures of the 646 patients enrolled in the ELOQUENT-2 study. The Brief-Pain Inventory-Short Form (BPI-SF), European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire-Core 30 module (QLQ-C30), and myeloma-specific module (QLQ-MY20) were used to assess PROs at screening, at the start of each treatment cycle, and at the end of treatment. Baseline scores for the questionnaires were similar between groups treated with ELd and Ld.

The mean baseline pain scores were low and remained low throughout the course of therapy among all patients, and HRQoL scores remained consistent from baseline.

Clinically meaningful improvements in worst pain were observed over 2 consecutive cycles in a significantly higher proportion of patients who had an objective response to treatment (29%) compared with those who did not (12%) (P < .001). Patients who had a very good partial response or better had improved scores for pain severity and worst pain; patients who experienced progressive disease reported worsened pain severity and worst pain, as well as increased pain interference.

Study results showed that the PFS and ORR benefit from ELd can be achieved without HRQoL or pain detriment among patients with RRMM. The authors concluded that “treatment responders showed more HRQoL and pain benefit than nonresponders, supporting the clinical relevance of PROs in MM care.”

Reference

  1. Cella D, Mckendrick J, Kudlac A, et al. Impact of elotuzumab treatment on pain and health-related quality of life in patients with relapsed or refractory multiple myeloma: results from the ELOQUENT-2 study [published online September 4, 2018]. Ann Hematol. doi: 10.1007/s00277-018-3469-4

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