A systematic literature review and network meta-analysis of treatments for patients with untreated multiple myeloma not eligible for stem cell transplantation
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A systematic literature review and network meta-analysis of treatments for patients with untreated multiple myeloma not eligible for stem cell transplantation. / Weisel, Katja; Doyen, Chantal; Dimopoulos, Meletios; Yee, Adrian; Lahuerta, Juan José; Martin, Amber; Travers, Karin; Druyts, Eric; Toor, Kabirraaj; Abildgaard, Niels; Lu, Jin; Van Droogenbroeck, Jan; Geraldes, Catarina; Petrini, Mario; Voillat, Laurent; Voog, Eric; Facon, Thierry.
In: LEUKEMIA LYMPHOMA, Vol. 58, No. 1, 01.2017, p. 153-161.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - A systematic literature review and network meta-analysis of treatments for patients with untreated multiple myeloma not eligible for stem cell transplantation
AU - Weisel, Katja
AU - Doyen, Chantal
AU - Dimopoulos, Meletios
AU - Yee, Adrian
AU - Lahuerta, Juan José
AU - Martin, Amber
AU - Travers, Karin
AU - Druyts, Eric
AU - Toor, Kabirraaj
AU - Abildgaard, Niels
AU - Lu, Jin
AU - Van Droogenbroeck, Jan
AU - Geraldes, Catarina
AU - Petrini, Mario
AU - Voillat, Laurent
AU - Voog, Eric
AU - Facon, Thierry
PY - 2017/1
Y1 - 2017/1
N2 - In newly diagnosed multiple myeloma (MM), patients ineligible for front-line autologous stem cell transplantation (ASCT), melphalan and prednisone (MP) with thalidomide (MPT) or bortezomib (VMP) are standard first-line therapeutic options. Despite new treatment regimens incorporating bortezomib or lenalidomide, MM remains incurable. The FIRST study demonstrated significant improvement in progression-free survival (PFS) and overall survival (OS) for the combination of lenalidomide and low-dose dexamethasone (Rd) until progression vs. MPT in transplant-ineligible ndMM patients. However, to date no head-to-head randomized controlled trials (RCTs) have compared Rd or MPT versus VMP. We conducted a network meta-analysis using RCTs identified through a systematic literature review to evaluate the relative efficacy of Rd versus other regimens on survival endpoints in previously untreated MM patients ineligible for ASCT. In this analysis, Rd was associated with a significant PFS and survival advantage versus other first-line treatments (VMP, MPT, MP), challenging the role of alkylators in this setting.
AB - In newly diagnosed multiple myeloma (MM), patients ineligible for front-line autologous stem cell transplantation (ASCT), melphalan and prednisone (MP) with thalidomide (MPT) or bortezomib (VMP) are standard first-line therapeutic options. Despite new treatment regimens incorporating bortezomib or lenalidomide, MM remains incurable. The FIRST study demonstrated significant improvement in progression-free survival (PFS) and overall survival (OS) for the combination of lenalidomide and low-dose dexamethasone (Rd) until progression vs. MPT in transplant-ineligible ndMM patients. However, to date no head-to-head randomized controlled trials (RCTs) have compared Rd or MPT versus VMP. We conducted a network meta-analysis using RCTs identified through a systematic literature review to evaluate the relative efficacy of Rd versus other regimens on survival endpoints in previously untreated MM patients ineligible for ASCT. In this analysis, Rd was associated with a significant PFS and survival advantage versus other first-line treatments (VMP, MPT, MP), challenging the role of alkylators in this setting.
KW - Antineoplastic Agents
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Humans
KW - Multiple Myeloma
KW - Neoplasm Staging
KW - Publication Bias
KW - Survival Analysis
KW - Treatment Outcome
KW - Journal Article
KW - Meta-Analysis
KW - Review
KW - Systematic Review
U2 - 10.1080/10428194.2016.1177772
DO - 10.1080/10428194.2016.1177772
M3 - SCORING: Review article
C2 - 27124703
VL - 58
SP - 153
EP - 161
JO - LEUKEMIA LYMPHOMA
JF - LEUKEMIA LYMPHOMA
SN - 1042-8194
IS - 1
ER -
