Health-related quality of life in patients with light chain amyloidosis treated with bortezomib, cyclophosphamide, and dexamethasone ± daratumumab: Results from the ANDROMEDA study

Am J Hematol. 2022 Jun 1;97(6):719-730. doi: 10.1002/ajh.26536. Epub 2022 Mar 30.

Abstract

In the phase 3 ANDROMEDA trial, patients treated with daratumumab, bortezomib, cyclophosphamide, and dexamethasone (D-VCd) had significantly higher rates of organ and hematologic response compared with patients who received VCd alone. Here, we present patient-reported outcomes (PROs) from the ANDROMEDA trial. PROs were assessed through cycle 6 using three standardized questionnaires. Treatment effect through cycle 6 was measured by a repeated-measures, mixed-effects model. The magnitude of changes in PROs versus baseline was generally low, but between-group differences favored the D-VCd group. Results were generally consistent irrespective of hematologic, cardiac, or renal responses. More patients in the D-VCd group experienced meaningful improvements in PROs; median time to improvement was more rapid in the D-VCd group versus the VCd group. After cycle 6, patients in the D-VCd group received daratumumab monotherapy and their PRO assessments continued, with improvements in health-related quality of life (HRQoL) reported through cycle 19. PROs of subgroups with renal and cardiac involvement were consistent with those of the intent-to-treat population. These results demonstrate that the previously reported clinical benefits of D-VCd were achieved without decrement to patients' HRQoL and provide support of D-VCd in patients with AL amyloidosis.

Publication types

  • Clinical Trial, Phase III

MeSH terms

  • Amyloidosis* / drug therapy
  • Antibodies, Monoclonal
  • Antineoplastic Combined Chemotherapy Protocols
  • Bortezomib
  • Cyclophosphamide
  • Dexamethasone
  • Humans
  • Immunoglobulin Light-chain Amyloidosis* / drug therapy
  • Immunoglobulin Light-chain Amyloidosis* / etiology
  • Multiple Myeloma* / drug therapy
  • Quality of Life
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • daratumumab
  • Bortezomib
  • Dexamethasone
  • Cyclophosphamide