Projects

MY-PROMPT-2: More efficient delivery of high-cost standard-of-care therapies in relapsed multiple myeloma using real-time feedback of patient-reported outcome measures: the MY-PROMPT-2 trial

Treatment of multiple myeloma (MM) is now very complex and costly. However, survival benefits achieved with new therapies in clinical trials are not being seen in clinical practice, in part because many MM patients stop therapy early, often due to side-effects. We hypothesise that if treating clinicians are made aware of emerging patient symptoms, thus informing timely intervention, duration on therapy can be optimised, enhancing treatment effectiveness and making more efficient use of these high-cost therapies. Routine use of patient-reported outcome measures (PROMs), including feedback to treating clinicians, has been shown to improve outcomes in non-haematological cancer populations, but has not been evaluated in MM care.

The study

We showed in the pilot MY-PROMPT randomised controlled trial, that real-time feedback of patient-reported outcome measures (PROMs) in MM is feasible and acceptable to patients and clinicians. The  MY-PROMPT-2 trial will build on this experience by testing whether real-time feedback of PROMs to clinicians improves event-free survival (time from randomisation to permanent discontinuation of treatment regimen) in patients with relapsed MM receiving PBS-funded standard of care (SoC), compared to SoC alone.

IMPROVE: Immunoglobulins in Myeloma Patients: Research into Outcomes, Variation in practice, and Epidemiology

Patients with multiple myeloma (MM) are at risk of infection because of low levels of protective antibodies, and immunoglobulin (Ig) therapy is used to replace missing antibodies to prevent or treat infections in MM. Ig therapy is expensive (more than $60 million dollars annually in MM) and blood cancers are the most common indication for its use in Australia, with increasing demand. 

There is substantial variation in Ig use in MM across Australia and the reason is unclear. Using the MRDR, this project will collect current ‘real world’ Australian clinical and laboratory information on Ig use to monitor practice, costs, and outcomes; to plan and deliver care; and to guide policy and clinical practice. We will also collect samples to store and test in future studies.

This study will also provide a new and lower cost framework for conducting future large clinical trials of Ig therapy in MM and similar conditions in Australia.

The study

IMPROVE is funded by the National Blood Authority and offers a $500 per patient payment for information on infection and immunoglobulin use in patients with MM. We have identified the target 300 patients across Australian MRDR sites. The IMPROVE blood biobank welcomes more participating sites in Victoria with a $200 additional per patient payment - a limited transport time restricts recruitment to within Victoria.