Table 4. . Patient/outcome assessments and schedule.
Parameter | Timing | Assessment | Prospective versus retrospective |
---|---|---|---|
Patient demographics | Baseline | – Age – Sex – Race – Ethnicity – Height – Weight – Insurance information – Geographic region |
Prospective |
Medical history at diagnosis | Baseline | – Date of initial diagnosis (month/year for RRMM; day/month/year for NDMM) and criteria used (ISS, R-ISS) – Stage (ISS or R-ISS) – Cytogenetics/FISH risk† – CRAB symptoms – Hematology: white blood cell count, absolute neutrophil count, hemoglobin, platelet count – Chemistry: calcium, creatinine, alkaline phosphatase, total bilirubin, aspartate aminotransferase, alanine aminotransferase, LDH, albumin, serum β2-microglobulin and BUN‡ – SPEP, serum FLC† and UPEP† – Imaging§ – History of MGUS/SMM – Frailty status: CCI, Katz Index of Independence in activities of daily living and Lawton instrumental activities of daily living scale – ECOG performance status |
NDMM patients: prospective RRMM patients: retrospective |
Medical history prior to study inclusion | Baseline | – Bone marrow – FLC† – M-component, immunofixation – Imaging§ – GEP† – Prodromal/other plasma cell disorders (MGUS, SMM, amyloidosis) – Plasmacytoma and extramedullary disease – Central nervous system involvement – Stem cell transplant – Vaccination |
NDMM patients: prospective RRMM patients: retrospective |
Medical evaluation | Baseline | – CCI – PN – Pneumococcal vaccine – Influenza A/B – Hypertension requiring treatment – Thromboembolism – Cardiac left ventricular function – Arrhythmias/pace-maker/AICD – Osteopenia/osteoporosis – Osteonecrosis of the jaw – Cataracts – MDS – MM-related radiation therapy – Orthopedic procedure/surgery for MM-related skeletal event – Other surgery/procedures |
Prospective |
Quarterly | – PN – Amyloidosis – Pneumonia – Herpes zoster infection – Hypertension – Thromboembolism – Cataracts – Osteonecrosis of the jaw – Skeletal-related events – Cardiac events |
Prospective | |
Yearly | – Height and weight – Vaccinations – MDS – Secondary primary malignancy – Frailty status: CCI, Katz Index of Independence in activities of daily living and Lawton instrumental activities of daily living scale – ECOG performance status |
Prospective | |
Prior therapies (RRMM) | Baseline | – RRMM: number of relapses and previous lines of therapy, regimens used in each line, prior SCT or consolidation/maintenance therapy, use of investigational therapy as part of a clinical trial, response, MRD† | Retrospective |
Disease management | Baseline and quarterly | – Current therapy: type of regimens and drugs (including duration of treatment, sequencing of therapies, retreatment and use of continuous versus fixed-duration therapy), factors associated with treatment initiation, reasons for not receiving therapy, response and MRD for each regimen†, SCT, supportive care | Prospective |
Quarterly | – Changes or modifications to treatment: drug, schedule, dose, line of therapy and reasons for these changes – Hematology and chemistry, safety, MM-related radiation therapy and surgeries/procedures |
Prospective | |
Effectiveness of treatment | Quarterly | – Bone marrow evaluation – FISH and/or cytogenetics† – MRD† – Imaging§ – NGS and GEP† – SPEP, serum FLC† and UPEP† – Response per IMWG criteria [31] – Progression status for each regimen – Date and cause of death |
Prospective |
PROs | Baseline and quarterly | – EORTC QLQ-C30: two items on Global Health Status/QoL subscale – EORTC QLQ-MY-20: single item on peripheral neuropathy – TSQM-9: effectiveness, convenience and global satisfaction domains |
Prospective |
HRU | Quarterly | – Inpatient and intensive care admissions – Reasons for admission and length of stay – Outpatient clinic visits – Emergency room visits |
Prospective |
Safety¶ | Baseline and quarterly | – AEs and SAEs leading to treatment discontinuation (temporary and permanent) or drug modification – Frequency of secondary primary malignancy |
Prospective |
†Assessment was performed if the test was available and carried out as part of routine practice at the study sites.
‡If available.
§Includes assessment of evidence of plasmacytoma, extramedullary disease, and diffuse involvement.
¶Based on the latest version the National Cancer Institute the Common Terminology Criteria for Adverse Events.
AE: Adverse event; AICD: Automatic implantable cardioverter-defibrillator; BUN: Blood urea nitrogen; CCI: Charlson comorbidity index; CRAB: hyperCalcemia, Renal insufficiency, Anemia, Bone lesions; ECOG: Eastern Cooperative Oncology Group; EORTC: European Organization for Research and Treatment of Cancer; FISH: Fluorescence in situ hybridization; FLC: Free light chain; GEP: Gene expression profiling; HRU: Healthcare resource utilization; IMWG: International Myeloma Working Group; ISS: International Staging System; LDH: Lactate dehydrogenase; MDS: Myelodysplastic syndrome; MGUS: Monoclonal gammopathy of undetermined significance; MM: Multiple myeloma; MRD: Minimal residual disease; NDMM: Newly diagnosed multiple myeloma; NGS: Next-generation sequencing; PN: Peripheral neuropathy; PRO: Patient self-reported outcomes; QLQ-C30: Quality of Life Questionnaire – Core 30 Module; QLQ-MY-20: Quality of Life Questionnaire – 20-item Multiple Myeloma Module; QoL: Quality of life; R-ISS: Revised International Staging System; RRMM: Relapsed/refractory multiple myeloma; SAE: Serious adverse event; SCT: Stem cell transplant; SMM: Smoldering multiple myeloma; SPEP: Serum protein electrophoresis; TSQM-9: 9-Item Treatment Satisfaction Questionnaire for Medication; UPEP: Urine protein electrophoresis.