Measuring Frailty In Relapsed/Refractory Multiple Myeloma Using Patient-Reported Outcomes Data

Abstract

Current frailty measurement systems in Multiple Myeloma weight patients’ chronological age heavily. The aim of this research was to explore the feasibility of measuring frailty in patients with Relapsed/Refractory Multiple Myeloma (RRMM) without factoring in chronological age and using patient responses to previously administered Patient Reported Outcome (PRO) questionnaires. Clinical trial data submitted to the U.S. Food and Drug Administration for regulatory review were analyzed to propose a Patient-Reported Frailty Phenotype or PRFP. PRFP was then applied to determine the prevalence of frailty in the study sample. PRFP was also compared descriptively against a proxy version of the current standard metric – the International Myeloma Working Group Frailty Index (IMWG FI). There was a fair level of agreement or concordance between the two measurement approaches. Both PRFP and IMWG FI proxy were then used to predict Overall Survival. Frailty – regardless of which frailty measurement system was used – was significantly associated with mortality, independent of disease stage, Eastern Cooperative Oncology Group Performance Status (ECOG PS), and other key confounders. Future research is needed to externally validate findings. This work represents an important step forward in embedding frailty into healthcare decision making, as PRFP appears to be a practical and resourceful approach to assessing frailty through pre-existing data.