Quality of Life in Multiple Myeloma Patients

Saad Usmani, MD, MBA, FACP, explores the burden of multiple myeloma on patient health-related quality of life [HRQoL] and why HRQoL results of clinical trials should be considered when making treatment decisions for this disease.

Saad Usmani, MD, MBA, FACP: When I started in the field as a myeloma researcher and clinician, the outlook for patients with myeloma was poor. The median overall survival [OS] used to be about 2 to 3 years, and patients had a significant burden on their quality of life with pain, fatigue, infections, hospitalizations, fractures, renal failures, and all of that end-organ damage. The quality of life was quite poor as patients passed away from the disease. Now fast forward 2 decades and look at how the OS has improved, we’re paying more attention to all of those quality of life items. We’ve been able to improve the OS to 10-plus years for the vast majority of patients, and now the focus is how can we improve their quality of life, and this is where it becomes important. We want our patients to get a good response, have the least amount of end-organ damage, the least amount of impact of myeloma in their day-to-day lives, and help them enjoy things that they once enjoyed before the myeloma diagnosis rocked their world. I think examining health-related quality of life measures as not just exploratory but important secondary end points in clinical trials becomes very impactful. We now have very effective newer therapies for myeloma. As we start comparing the usual or standard-of-care way of treating myeloma to some of these newer treatments, we want to make sure we’re doing it for the right reasons, and making sure that health-related quality of life measures are not impacted adversely by these newer therapies.

I think the key message is that good responses and good depth of responses are important for all patients with myeloma regardless of their frailty score, and help improve patients’ quality of life. The other important key message from the MAIA trial, in general, is that if you have an effective regimen, you can get older patients with myeloma into a good response, albeit with modifications of doses of drugs. Then [we need to] monitor these patients closely for safety and adverse events, and make sure we are able to interrupt treatments and modify doses at the right time during the course of treatment. Looking at the 30,000-feet kind of view, I think these health-related quality of life data from MAIA help us appreciate that disease control does lead to a better quality of life for patients. We have to find good, tolerable regimens to make that happen for our patients.

Transcript edited for clarity.

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