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. 2024 Nov 18;32(12):802.
doi: 10.1007/s00520-024-08985-3.

Symptom experience of patients undergoing treatment for multiple myeloma: a longitudinal real-world electronic patient-reported outcomes study

Mihir N Patel  1 , Anneli Nina  2 , Brenda Branchaud  2 , Kris W Herring  2 , Suzanne Johnson  3 , Julie Scott  3 , Thomas W LeBlanc  4   5
Affiliations

Symptom experience of patients undergoing treatment for multiple myeloma: a longitudinal real-world electronic patient-reported outcomes study

Mihir N Patel et al. Support Care Cancer. .

Abstract

Purpose: Patients with multiple myeloma (MM) experience significant symptom burden. We used a symptom monitoring app to longitudinally characterize the MM treatment experience in detail based on line of therapy (LOT).

Methods: Adults with MM on active treatment completed weekly symptom monitoring surveys. Patients on their 4th LOT or greater were considered heavily pretreated. We characterized moderate to very severe (MOD-VS) symptom prevalence, weekly symptom burden, symptom bother (FACT-GP5), and health-related quality of life (HR-QoL) (EORTC QLQ-C30 Item 30) per LOT.

Results: We considered 109 patients on LOT < 4 and 47 on LOT ≥ 4. The top MOD-VS symptoms were fatigue (71.6% of patients), muscle pain (59.8%), general pain (51.6%), numbness/tingling (48.4%), and insomnia (47.6%). More patients on LOT ≥ 4 experienced numbness/tingling (66.7% vs. 41.3%; OR 2.84, 95% CI 1.27-6.37; p = 0.0098) and fatigue (83.3% vs. 65.6%; OR 2.60, 95% CI 0.96-7.09; p = 0.0557). Some symptoms (fatigue, muscle pain, anxiety) persisted for months among patients on LOT ≥ 4, but patients on LOT < 4 also had unmet longitudinal needs (numbness/tingling, dyspnea). Patients on LOT ≥ 4 had more weeks with ≥ 3 MOD-VS symptoms (27.1% of weeks vs. 15.7%; OR 2.56, 95% CI 1.07-6.08; p = 0.0337) and experienced high symptom bother more often (39.1% of surveys vs. 30.0%; OR 4.23, 95% CI 1.37-13.10; p = 0.0123). HR-QoL was similar between groups.

Conclusion: Heavily pretreated patients experienced greater symptom burden and bother, but patients at earlier LOTs also had unmet needs. Interventions are needed to improve symptom management in MM regardless of LOT, but most pressingly for heavily pretreated patients.

Keywords: Digital health; Multiple myeloma; Patient-reported outcomes; Quality of life; Symptom burden.

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Conflict of interest statement

Declarations Ethics approval This study was performed in accordance with the Declaration of Helsinki. This study utilized a prospectively collected database of electronic patient-reported outcomes; we obtained approval from the Institutional Review Board at Duke University Medical Center for analysis of these data (Pro00108428). Consent to participate Informed consent was obtained from all individual participants included in the study. Competing interests Mihir N. Patel has received royalties from Prepped Health (Agreement #012617, HOPE). Suzanne Johnson and Julie Scott are employees of and hold stock or stock options in Carevive Systems, Inc. Thomas W. LeBlanc has received honoraria for consulting/advisory boards from AbbVie, Agilix, Agios/Servier, Apellis, Astellas, AstraZeneca, Beigene, BlueNote, BMS/Celgene, Genentech, GSK, Lilly, Meter Health, Novartis, and Pfizer; speaking related honoraria from AbbVie, Agios, Astellas, BMS/Celgene, GSK, Incyte, and Rigel; equity interest in Dosentrx and ThymeCare (stock options in a privately-held company); royalties from UpToDate; research funding from AbbVie, American Cancer Society, AstraZeneca, BMS, Deverra Therapeutics, Duke University, GSK, Jazz Pharmaceuticals, the Leukemia and Lymphoma Society, the National Institute of Nursing Research/ National Institutes of Health, and Seattle Genetics. All other authors have no relevant financial or non-financial interests to disclose.

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