Abstract：
Because of lacking of head-to-head comparison among recently effective novel agents\' combination regimens for newly diagnosed patients with mantle-cell lymphoma (MCL) who are ineligible for intensive therapy like autologous stem-cell transplantation, the optimal option for these patients still remains undefined. We searched relevant published reports. Three randomized controlled trials with 1459 subjects were identified. In the network meta-analysis, ibrutinib plus bendamustine and rituximab (Ibru + BR) significantly improved progression-free survival (PFS) when compared to bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP; hazard ratio [HR]: 0.55, p = .03) and rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP; HR: 0.35, p < .001) for newly diagnosed patients with MCL ineligible for intensive therapy. Among these first-line treatment regimens (Ibru + BR, VR-CAP, R-CHOP, and BR), Ibru + BR had the highest probability of 94.9% to be the best intervention in PFS analysis. No significant difference was found in adverse events analysis. Our data indicated that Ibru + BR seemed to prolong the PFS when compared to VR-CAP and R-CHOP for newly diagnosed patients with MCL ineligible for intensive therapy. Considering our limits, prospective clinical trials directly comparing these regimens are warranted.
摘要：
由于缺乏头对头的比较，最近有效的新型药物组合方案对新诊断的套细胞淋巴瘤（MCL）患者不适合进行强化治疗，如自体干细胞移植，这些患者的最佳选择仍未确定.我们搜索了相关的已发表报告。鉴定了三个具有1459名受试者的RCT。在网络荟萃分析中，与硼替佐米相比，伊布替尼联合苯达莫司汀和利妥昔单抗（Ibru+BR）显着改善了无进展生存期（PFS），利妥昔单抗,环磷酰胺,阿霉素,和泼尼松（VR-CAP）（HR：0.55，P=0.03）和利妥昔单抗，环磷酰胺,阿霉素,长春新碱,和泼尼松（R-CHOP）（HR：0.35，P<0.001）用于新诊断的MCL患者不适合进行强化治疗。在这些一线治疗方案中(Ibru+BR，VR-CAP,R-CHOP和BR），Ibru+BR作为PFS分析中最佳干预的概率最高，为94.9%。在AE分析中没有发现显著差异。我们的数据表明，对于新诊断的MCL患者，与VR-CAP和R-CHOP相比，IbruBR似乎延长了PFS。考虑到我们的局限性,有必要直接比较这些方案的前瞻性临床试验.
