Source: Myeloma – Hematology Advisor
A single question can be used to predict early treatment discontinuation in patients with multiple myeloma (MM), according to research published in JAMA Network Open.
Researchers found that a patient’s response to item 5 from the Functional Assessment of Cancer Therapy-General General Physical Wellbeing Scale (GP5) was significantly associated with subsequent treatment discontinuation because of adverse events (AEs).
Item GP5 is “I am bothered by side effects of treatment,” and responses include “very much,” “quite a bit,” “somewhat,” “a little bit,” and “not at all.”
The researchers evaluated GP5 responses from 1058 patients with MM enrolled in the E1A11 trial (ClinicalTrials.gov Identifier: NCT01863550).
The trial enrolled patients with newly diagnosed, standard-risk MM. They were randomly assigned to receive either bortezomib, lenalidomide, and dexamethasone (n=531) or carfilzomib, lenalidomide, and dexamethasone (n=527) as induction, followed by maintenance. Only data from the induction phase were used in this analysis.
The patients answered GP5 at baseline, 1 month, 2.8 months, and 5.5 months. Responses of “very much” or “quite a bit” were categorized as “high bother” from AEs. Responses of “somewhat,” “a little bit,” and “not at all” were categorized as “low bother” from AEs.
In an adjusted analysis, the odds of early treatment discontinuation were higher for patients with high bother from AEs at 1 month than for those with low bother from AEs at 1 month (adjusted odds ratio [aOR], 2.20; 95% CI, 1.25-3.89).
The odds of early treatment discontinuation for patients with high bother from AEs increased at 2.8 months (aOR, 3.41; 95% CI, 2.01-5.80) and at 5.5 months (aOR, 4.66; 95% CI, 1.69-12.83).
The researchers also noted that the baseline-adjusted, maximum GP5 value while undergoing treatment was significantly associated with early treatment discontinuation for patients with high bother from AEs (aOR, 1.54; 95% CI, 1.04-2.30).
Patients had higher odds of early treatment discontinuation if they experienced worsening of 2 or more GP5 categories from baseline to 2.8 months (aOR, 3.02; 95% CI, 1.64-5.54) and to 5.5 months (aOR, 5.49; 95%CI, 1.45-20.76). There were no such associations at 1 month or for worsening of only 1 category.
“These results point to the usefulness of GP5 as an overall AE impact measure for patients receiving treatment,” the researchers wrote. “Because it is very brief, GP5 may be very useful as a low-burden way to track treatment tolerability over time, both in the context of clinical trials and in routine care.”
Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.