Clinical trial NCT05284591: Non-interventional Study to Evaluate Patient and Healthcare Provider Satisfaction of Daratumumab Use in the Treatment of First-line Daratumumab, Lenalidomide, Dexamethasone (DRd) Multiple Myeloma Patients in Germany Depending on Application Route (sc or iv)
Official title: Prospective, Multicenter, Non-interventional Study to Evaluate Patient and Healthcare Provider Satisfaction of Daratumumab Use in the Treatment of First-line Daratumumab, Lenalidomide, Dexamethasone (DRd) Multiple Myeloma Patients as Per Routine Clinical Practice in Germany Depending on Application Route (sc or iv)
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Multiple Myeloma
Newly Diagnosed
Transplant Ineligible
Patient Satisfaction
Patient Preference
Personal Satisfaction
Keywords: Daratumumab
DARZALEX
Lenalidomide
Dexamethasone
Lead sponsor: iOMEDICO AG
Sponsor class: INDUSTRY
First posted: 2022-03-17
Enrollment: 96
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: MYLENE is focusing on the satisfaction of all involved stakeholders (i.e., patients and HCPs) mainly in private practices, since this patient collective is treated preferentially in these institutions, allowing to receive direct feedback about the use of daratumumab sc application and its potential hurdles or/and limitations.

Brief summary: MYLENE is a prospective, multicenter, NIS to evaluate the patient and HCP satisfaction of sc and iv application of daratumumab in routine clinical practice in Germany. Patients observed in this study will be transplant ineligible NDMM patients for which the physician foresees an anti-myeloma therapy using DRd regimen as per local label.

250 NDMM patients treated with DRd will be enrolled (excluding screening failures, i.e., enrolled patients not fulfilling selection criteria identified before treatment start will be replaced) within 12 months in a proportion of approximately 1/3 patients receiving daratumumab sc and 2/3 patients receiving daratumumab iv as per physician's decision.

Detailed description: Therapy options for MM are mainly dependent on the age and fitness of the patients. NDMM patients up to the age of 65-70 years in whom autologous stem cell transplantation is not indicated, anti-myeloma treatment traditionally consists of systemic chemotherapy, with adjunctive use of radiation or surgery in selected cases associated with extramedullary disease. However, the therapeutic landscape of multiple myeloma progressed in the past decade with the introduction of immunomodulatory agents, proteasome inhibitors and anti-CD38 antibodies, like Daratumumab.

After approval of daratumumab iv in May 2016, the sc daratumumab application route was approved in June 2020 in Germany. Real-world evidence data, however, are not yet available neither related to daily experience nor to satisfaction with daratumumab sc application nor to the proportion of patients potentially switching from daratumumab iv to sc application.

MYLENE aims to close these gaps with focus on NDMM patients who are ineligible for autologous stem cell transplantation and who will be treated with DRd; this is to guarantee a homogenous patient population.

All aspects of treatment and clinical management of patients will be in accordance with local clinical practice and applicable local regulations, and at the discretion of the healthcare provider (or treating physician where different). Only data available per clinical practice will be collected within this study. Additionally, where permitted in accordance with local regulations, healthcare providers will be asked to obtain patient-reported outcome (PRO) data from patients within this study. Despite use of PROs and HCP as well as physician questionnaires, the design is non-interventional due to the fact that the questionnaires are structured documentation aids to document questions that are routinely part of the dialog between patient and physician or HCP during the patient visit and/or drug administration or that are considered by the HCP when evaluate treatment for the patient but are not documented in the medical record.

MYLENE is unique as it is focusing on the satisfaction of all involved stakeholders (i.e., patients and HCPs) under real-word conditions and mainly in private practices, since this patient collective is treated preferentially in these institutions, allowing to receive direct feedback about the use of daratumumab sc application and its potential hurdles or/and limitations. Furthermore, this study will provide insights on how the sc/iv application is managed in clinical routine as well as how it is perceived by medical professionals over time.

This NIS will be analyzed exploratively and is hence not designed to confirm or refute a predefined hypothesis.

Eligibility criteria: Inclusion Criteria:

* Patients aged 18 years or older
* Newly diagnosed multiple myeloma (NDMM) and decision for first-line treatment with daratumumab/lenalidomide/dexamethasone (DRd) according to SmPCs of daratumumab
* Each patient must sign an informed consent form (ICF) indicating that he or she understands the purpose of the study and is willing to participate in the study
* Willingness and ability to read, understand and complete patients' questionnaires due to the primary objective of the NIS (i.e., patient satisfaction using the Patient Satisfaction and Time Questionnaire (PatSTQ)).

Exclusion Criteria:

* Participation in an interventional clinical trial (participation in another non-Janssen sponsored NIS or registry is allowed)
* Prior anti-myeloma therapy, with the exception of local radiation therapy or an emergency use of a short course of corticosteroids before treatment
* Any restrictions/limitations preventing to be treated with DRd as per SmPCs of daratumumab

Primary outcomes:
measure: Patient Satisfaction and Time with the application route of daratumumab (iv/sc)
timeFrame: For patients with continuous application route the time frame will be 12 months. For patients with switch of application route, at least 4 daratumumab applications after the first switch should be documented.
Secondary outcomes:
measure: HCP satisfaction and time with the application route of daratumumab (iv/sc)
timeFrame: Time frame will be approx. 12 months depending on switch of application route.
measure: Proportion of HCP active time spent on activities
timeFrame: Time frame will be approx. 12 months depending on switch of application route.
measure: Patients' chair time over time
timeFrame: Time frame will be approx. 12 months depending on switch of application route.
measure: Patients' overall time spent at doctor's office
timeFrame: Time frame will be approx. 12 months depending on switch of application route.
measure: Switch rate (proportion of patients) of daratumumab application routes
timeFrame: Time frame will be approx. 12 months depending on switch of application route.
measure: Median switch time
timeFrame: Time frame will be approx. 12 months depending on switch of application route.
measure: Main reasons for sc or iv application selection
timeFrame: Time frame will be from date of site activation (start of potential enrolment at site) to site close-out (up to 14 months after last patient in)..
measure: Impact of different factors on therapy decision and application route selection (PTDQ-ps)
timeFrame: Time frame will be approx. 12 months depending on switch of application route.
measure: Patients' preference of the application route
timeFrame: Time frame will be approx. 12 months depending on switch of application route.
Other outcomes:
measure: Safety and tolerability of daratumumab treatment. Occurence and number of patients with adverse events as assessed by CTCAE.
timeFrame: Time frame will be approx. 12 months depending on switch of application route. (On-treatment period: from day of first dose of daratumumab to 30 days after last dose of daratumumab, or end of documentation period, whatever comes first.)
Locations:
city: Frankfurt
country: Germany
facility: Centrum für Hämatologie und Onkologie Bethanien
state: Hessen
Study officials:
affiliation: Centrum für Hämatologie und Onkologie Bethanien, Frankfurt/ Main
name: Wolfgang Knauf, Prof. Dr.
role: PRINCIPAL_INVESTIGATOR
References: