title: Bortezomib is associated with better health-related quality of life than high-dose dexamethasone in patients with relapsed multiple myeloma: results from the APEX study.
abstract: Health-related quality of life (HRQL) was prospectively measured during the phase III APEX trial of bortezomib versus dexamethasone in relapsed multiple myeloma patients. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core (QLQ-C30) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (NTX) side-effects questionnaires were administered at baseline and every 6 weeks up to 42 weeks. Patients receiving bortezomib (1.3 mg/m(2), days 1, 4, 8 and 11 for eight 3-week cycles, then days 1, 8, 15 and 22 for three 5-week cycles; n = 296) demonstrated significantly better mean Global Health Status over the study versus patients receiving dexamethasone (40 mg/d, days 1-4, 9-12, and 17-20 for four 5-week cycles, then days 1-4 only for five 4-week cycles; n = 302), plus significantly better physical health, role, cognitive, and emotional functioning scores, lower dyspnoea and sleep symptom scores, and better NTX questionnaire score, using multiple imputation to account for missing data. Results were similar using available-data analyses. Sensitivity analyses suggested that improved HRQL with bortezomib is at least partially explained by improved survival. These results show that bortezomib was associated with significantly better multidimensional HRQL compared with dexamethasone, consistent with the better clinical outcomes seen with bortezomib.
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA, USA. sjlee@fhcrc.org
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
authors.forename: Paul G
authors.initials: PG
authors.lastname: Richardson
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Michael W
authors.initials: MW
authors.lastname: Schuster
authors.forename: David
authors.initials: D
authors.lastname: Irwin
authors.forename: Jesús-F
authors.initials: JF
authors.lastname: San Miguel
authors.forename: Bruce
authors.initials: B
authors.lastname: Crawford
authors.forename: Joseph
authors.initials: J
authors.lastname: Massaro
authors.forename: Ravinder
authors.initials: R
authors.lastname: Dhawan
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gupta
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D003907:Dexamethasone / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000523:psychology; D011719:Pyrazines / Q000627:therapeutic use*; D011788:Quality of Life; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone