Abstract:
In view of the increasing data evaluating carfilzomib-based induction for newly-diagnosed multiple myeloma (NDMM), we conducted a systematic review and meta-analysis comparing the efficacy of carfilzomib/lenalidomide/dexamethasone (KRd) versus bortezomib/lenalidomide/dexamethasone (VRd). Three studies totaling 1597 patients (50% KRd-treated, 50% VRd-treated) were included. Despite similar survival outcomes and overall response rate compared with the VRd arm, KRd-treated subjects showed higher odds of achieving complete responses and measurable residual disease negativity. Among patients with high-risk cytogenetics (n = 348), KRd was associated with significant improvement in progression-free survival (HR = 0.70; 95% CI = 0.50-0.97; p = .03; I2 = 0%), suggesting carfilzomib-based induction may be preferable in this NDMM subpopulation.
摘要:
鉴于评估基于卡非佐米的新诊断多发性骨髓瘤(NDMM)诱导的数据越来越多,我们进行了系统评价和荟萃分析,比较了卡非佐米/来那度胺/地塞米松(KRd)与硼替佐米/来那度胺/地塞米松(VRd)的疗效.三项研究共1597名患者(50%KRd治疗,包括50%VRd处理的)。尽管与VRd组相比,生存结果和总反应率相似,KRd治疗的受试者显示出更高的实现完全反应和可测量的残留疾病阴性的几率。在高危细胞遗传学患者中(n=348),KRd与无进展生存期的显著改善相关(HR=0.70;95%CI=0.50-0.97;p=0.03;I2=0%),这表明在这个NDMM亚群中,基于卡非佐米的诱导可能是优选的。