Health-Related Quality of Life During Carfilzomib–Lenalidomide–Dexamethasone Consolidation: Findings From the Multiple Myeloma CONPET Study

Abstract

Background

In the CONPET study, multiple myeloma patients with abnormal 18FDG positron emission/computed tomography scan after upfront autologous stem cell transplantation were treated with four cycles of carfilzomib–lenalidomide–dexamethasone (KRd). Side effect registrations show that carfilzomib might cause dyspnea, cough, respiratory tract infections, and heart failure. The aims were to investigate patient-reported shortness of breath and dyspnea during KRd consolidation.

Methods

To assess shortness of breath, patients completed the Functional Assessment of Cancer Therapy—Pulmonary Symptom Index (FACT-PSI) and the EORTC QLQ-C30 to assess dyspnea. Shortness of breath was defined as decrease in FACT-PSI score or starting/increasing diuretic drugs. Mixed effect logistic regression was used for the effect analysis. Linear mixed model and clinical relevance were used to investigate dyspnea.

Results

A total of 50 patients were included, median age 62 years (interquartile range 54–67). 17% reported shortness of breath at Day 15 Cycles 1–4 versus 11% at Day 1 Cycles 2–4, Cycle 4 Day 29, and 1 month posttreatment (p-value 0.048). Compared with baseline, patients reported significant, and clinically relevant worsening in dyspnea during consolidation.

Conclusion

Our study confirmed earlier findings of carfilzomib causing shortness of breath during KRd administration and revealed dyspnea during consolidation compared to baseline.

Trial Registration

Clinicaltrials.gov: NCT03314636, EudraCT: 2017–000586-72