Comparing Efficacy and Survivals of Initial Treatments for Elderly Patients with Newly Diagnosed Multiple Myeloma: a Network Meta-analysis of Randomized Controlled Trials

Overview

Journal Onco Targets Ther

Publisher Dove Medical Press

Specialty Oncology

Date 2017 Jan 6

PMID 28053546

Citations 4

Authors

Xiaoping Liu

Jiarui Chen

Yuncen A He

XiangYu Meng

Kaili Li

Colin K He

Shangqin Liu

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to evaluate the efficacy and clinical outcome of initial therapies for elderly patients with multiple myeloma (MM).

Methods: Randomized controlled trials (RCTs) were obtained through a comprehensive search. Response rate, progression-free survival (PFS) and overall survival (OS) were the interested outcome measures. Network meta-analysis (NMA) using graph theory methodology to construct an NMA model, and sensitivity analysis were performed.

Results: Nineteen RCTs containing 7,235 participants and 17 treatments were included in the NMA. As compared to the classic melphalan plus prednisone (MP) regimen, the majority of other initial regimens showed higher rates of complete response/near complete response, overall response rate (ORR) and better PFS as well as OS. These four outcomes favored the two lenalidomide plus dexamethasone regimens (continuous lenalidomide and 18 cycles of lenalidomide plus dexamethasone), especially continuous lenalidomide plus dexamethasone regimen, over the majority of other regimens including the two established standard treatments (MP plus thalidomide or bortezomib) for elderly patients with newly diagnosed MM.

Conclusion: Continuous lenalidomide plus dexamethasone ranked as the best regimen in terms of ORR and OS for the treatment of elderly patients with newly diagnosed MM.

Citing Articles

Multiple drug combinations of bortezomib, lenalidomide, and thalidomide for first-line treatment in adults with transplant-ineligible multiple myeloma: a network meta-analysis.

Piechotta V, Jakob T, Langer P, Monsef I, Scheid C, Estcourt L Cochrane Database Syst Rev. 2019; 2019(11).

PMID: 31765002 PMC: 6876545. DOI: 10.1002/14651858.CD013487.

Development and Validation of a 9-Gene Prognostic Signature in Patients With Multiple Myeloma.

Liu X, Yin X, Meng X, Yan X, Wang F, He L Front Oncol. 2019; 8:615.

PMID: 30671382 PMC: 6331463. DOI: 10.3389/fonc.2018.00615.

The Expression of Actin-Related Protein 2/3 Complex Subunit 5 (ARPC5) Expression in Multiple Myeloma and its Prognostic Significance.

Xiong T, Luo Z Med Sci Monit. 2018; 24:6340-6348.

PMID: 30201948 PMC: 6144731. DOI: 10.12659/MSM.908944.

Maintenance Treatment and Survival in Patients With Myeloma: A Systematic Review and Network Meta-analysis.

Gay F, Jackson G, Rosinol L, Holstein S, Moreau P, Spada S JAMA Oncol. 2018; 4(10):1389-1397.

PMID: 30098165 PMC: 6233774. DOI: 10.1001/jamaoncol.2018.2961.

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