Policy Brief 2: Building Community Resilience

Building resilience in Ocean Cities of the Pacific region is key to converting challenges and risks communities face into opportunities for systemic transformation toward sustainable development. Island settlements at the nexus of ocean health, climate change and urban development will need to build anticipatory, adaptive, absorptive and transformative capacity in the face of complex stressors. The interlinked challenges and resource constraints in rapidly growing Ocean Cities in the Pacific means that the ability to absorb shocks and bounce back relevant partners and stakeholders to promote equitable opportunities for all people in urban communities to access resources and use them sustainably, and to apply standardized methods contextualized for the Pacific to assess the relative vulnerability of communities in Ocean Cities. It also recognizes the importance of promoting stronger governance regimes within urban communities, aligning these with the policies of local government, and encouraging partnerships between urban and rural communities. This second policy brief in the Ocean Cities series offers guidance in this direction

Health-related quality of life in transplant ineligible newly diagnosed multiple myeloma patients treated with either thalidomide or lenalidomide-based regimen until progression: a prospective, open-label, multicenter, randomized, phase 3 study

Data on the impact of long term treatment with immunomodulatory drugs (IMiD) on health-related quality of life (HRQoL) is limited. The HOVON-87/NMSG18 study was a randomized, phase 3 study in newly diagnosed transplant ineligible patients with multiple myeloma, comparing melphalan-prednisolone in combination with thalidomide or lenalidomide, followed by maintenance therapy until progression (MPT-T or MPR-R). The EORTC QLQ-C30 and MY20 questionnaires were completed at baseline, after three and nine induction cycles and six and 12 months of maintenance therapy. Linear mixed models and minimal important differences were used for evaluation. 596 patients participated in HRQoL reporting. Patients reported clinically relevant improvement in global quality of life (QoL), future perspective and role and emotional functioning, and less fatigue and pain in both arms. The latter being of large effect size