Impact of performance status on overall survival in patients with relapsed and/or refractory multiple myeloma: Real‐life outcomes of daratumumab treatment. (29th May 2020)

• Record Type: Journal Article
• Authors: Afram, Garbriel; Gran, Charlotte; Borg Bruchfeld, Johanna; Wagner, Arnika Kathleen; Hussain, Alamdar; Alici, Evren; Nahi, Hareth
• Is Part Of: European journal of haematology. Volume 105:Number 2(2020)
• Page Start: 196
• Page End: 202
• Publication Date: 2020-05-29
• Subjects: multiple myeloma -- quality of life -- supportive care; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.13426
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: Background: Little is reported on the real‐life impact of daratumumab in relapsed and/or refractory multiple myeloma patients (RRMM). We analyzed a cohort of 156 patients who received daratumumab as a single agent concerning ECOG status, eGFR, cytogenetics, lines of prior treatment, and their impact on survival. Results: Eighty‐two (53%) patients were triple refractory, 54 (35%) patients were single or double refractory, and 20 (12%) patients were non‐refractory. Following daratumumab treatment, the progression‐free survival (PFS) in these groups was 7.2%, 11.4%, and 53% ( P < .001), and overall survival (OS) was 34%, 73%, and 58% ( P < .001) at 36 months, respectively. Poor ECOG, three lines of prior treatment, and triple refractoriness were all associated with inferior PFS and OS in a multivariate analysis including ECOG, high‐risk chromosomal aberrations, refractoriness, number of treatment lines, and eGFR. Conclusion: Daratumumab remains an attractive treatment option, especially in patients with poor performance and increased frailty. Furthermore, our observations suggest that patients with ECOG 2 and 3 status require additional supportive and/or palliative therapies to compensate for a potentially effective but encompassing late‐line therapy. In conclusion, further prospective studies are needed to elucidate the impact of ECOG 2 and 3 status in patients with RRMM.