Forest plots of daratumumab OS efficacy (vs. therapies with out daratumumab) in line with (A) low- and (B) high-physical operate. Credit score: European Journal of Haematology (2025). DOI: 10.1111/ejh.14410
How most cancers sufferers counting on daratumumab really feel bodily earlier than beginning the remedy can predict how lengthy they may reside and the way properly they may reply to the anti-multiple myeloma (MM) drug, in line with a brand new research printed within the European Journal of Haematology.
The research analyzed knowledge from 1,804 sufferers enrolled in three large-scale medical trials—MAIA, POLLUX, and CASTOR. Throughout these trials, the median affected person age was 66 years, and 44% have been feminine. About half of the sufferers have been randomly assigned to obtain daratumumab-containing remedy, whereas the opposite half acquired commonplace remedies with out daratumumab.
Sufferers have been requested, earlier than beginning remedy, to finish a standardized questionnaire assessing their capability to hold out on a regular basis duties. This patient-reported measure of bodily operate was then used to look at whether or not it may predict survival and response to daratumumab-based remedy.
“The responses revealed that patients with lower scores benefited more from daratumumab, lived longer, and had a lower risk of disease progression,” famous lead writer Dr. Ahmad Abuhelwa from the College of Sharjah. “This is the first study to demonstrate that patient-reported physical function at treatment initiation can predict which patients derive the greatest survival benefit from daratumumab, a monoclonal antibody widely used in the treatment of multiple myeloma.”
The research gives a easy, low-cost means to enhance remedy choices, notably for older or frail sufferers.
“How well cancer patients can perform daily tasks—like walking or getting dressed—is a powerful predictor of survival outcomes and treatment benefit in people with multiple myeloma receiving daratumumab-based therapies.” Dr. Abuhelwa went on.
The research discovered that sufferers who reported having extra issue with on a regular basis bodily actions skilled the best profit from daratumumab remedy. On this low bodily operate group, daratumumab decreased the chance of loss of life from any trigger by 47% (hazard ratio 0.53 [95% CI: 0.40–0.70], P
In distinction, sufferers who reported being bodily properly earlier than remedy—the excessive bodily operate group—had much less profit. Their danger of loss of life was decreased by solely 14%, which was not statistically vital (HR 0.86 [0.62–1.19], P = 0.364) in comparison with these not receiving daratumumab. They did, nonetheless, expertise a 47% discount within the danger of most cancers development (HR 0.53 [0.42–0.67], P = 0.034), displaying that whereas daratumumab was nonetheless efficient on this group, the magnitude of profit was smaller (47%) than that seen in sufferers with low bodily operate (66%).
These outcomes held true whatever the affected person’s age, intercourse, weight, most cancers stage, doctor-assessed well being rating (ECOG), or variety of different well being issues. Curiously, the generally used physician score of a affected person’s normal well being (ECOG) didn’t assist predict who would profit extra—however the sufferers’ personal stories of their bodily operate did.
“Physical function is a predictive and prognostic marker that complements ECOG-PS, supporting its use in informing therapy decisions for daratumumab-based treatments,” the authors write.
Docs typically use the ECOG Efficiency Standing—a scale from 0 (totally lively) to five (lifeless)—to find out how properly a affected person is functioning. However the research, in line with Dr. Abuhelwa, discovered that many sufferers categorised as “fully active” by ECOG reported vital bodily challenges themselves.
Forest plots of daratumumab PFS efficacy (vs. therapies with out daratumumab) in line with (A) low- and (B) high-physical operate. Credit score: European Journal of Haematology (2025). DOI: 10.1111/ejh.14410
“Patient-reported scores gave a more accurate and sensitive prediction of survival and treatment effect. This highlights a critical gap—ECOG alone may not capture the full picture. We need to start listening to patients.”
The authors draw two main conclusions from their in depth evaluation.
Within the first, they discovered that sufferers who reported decrease bodily operate at remedy initiation acquired the best survival profit from daratumumab. Within the second, the evaluation discovered that sufferers with larger bodily operate confirmed a much less pronounced remedy profit.
“These findings were independent of traditional doctor-assessed tools, such as ECOG performance status. In fact, patient-reported scores outperformed ECOG in predicting survival outcomes. Importantly, daratumumab did not lead to more serious side effects in patients with low physical function,” Dr. Abuhelwa factors out. “Bottom line: What patients say about their physical limitations—right at the start of therapy—provides critical, actionable insights to guide cancer treatment decisions.”
Sufferers with a number of myeloma are sometimes handled with complicated therapies like daratumumab—a life-prolonging monoclonal antibody that may additionally carry dangers. A number of myeloma is turning into an growing world burden. In 2022, there have been an estimated 188,000 new circumstances and 121,000 deaths worldwide. By 2045, incidence and mortality are anticipated to rise by 71% and 79% respectively. In the USA alone, the American Most cancers Society tasks roughly 36,110 new circumstances and 12,030 deaths from a number of myeloma in 2025.
On the significance of the research, co-author Dr. Ashley Hopkins, Affiliate Professor at Flinders College in Australia, mentioned, “This is a timely and significant contribution. It highlights how patient-centered data can meaningfully guide complex treatment decisions in oncology. The study serves as a strong reminder to health professionals to seriously consider what cancer patients say about their physical function before initiating treatment.”
Prof. Humaid Al-Shamsi, a co-author from the UAE’s Burjeel Most cancers Institute, added, “This study highlights the growing importance of patient-centered care in oncology. By listening closely to how patients feel at the start of treatment, we can better personalize therapies and improve outcomes—especially for those who are older or more physically vulnerable. It’s a step forward in making cancer care more precise, compassionate, and effective.”
The authors recommend their research may have wide-reaching implications. In it, they name on clinicians to include patient-reported bodily operate into remedy planning; urge policymakers to advertise using patient-reported outcomes (PROs) in medical trials and routine care; and encourage drug builders to think about PROs when designing future most cancers research.
Nevertheless, they maintained that additional analysis and potential research have been warranted to substantiate the recognized remedy advantages and discover whether or not they would prolong to different up to date a number of myeloma remedy regimens.
Mentioned Dr. Abuhelwa, “With further validation, patient-reported outcomes could become an essential part of personalized treatment strategies, ultimately improving both survival and quality of life for people living with multiple myeloma.”
The analysis is the result of a collaboration amongst scientists from H. Lee Moffitt Most cancers Heart (U.S.), Flinders College (Australia), the College of North Carolina (U.S.), and the Burjeel Most cancers Institute within the United Arab Emirates (UAE).
Extra data:
Ahmad Y. Abuhelwa et al, Predictive and Prognostic Significance of Affected person‐Reported Outcomes for Survival and Hostile Occasions in Daratumumab‐Handled A number of Myeloma, European Journal of Haematology (2025). DOI: 10.1111/ejh.14410
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