PDF(Pubmed)
Abstract：
Although the significant strides in novel therapeutic approaches have prolonged the survival of multiple myeloma (MM) patients, the unfavorable prognosis of cytogenetically high-risk newly diagnosed MM (NDMM) remains intractable with the lack of consensus regarding the choice of maintenance regimens. Therefore, this study was initiated with the aim of examining the effectiveness of various maintenance treatments for this group of patients in jeopardy. Overall, 17 studies with 1937 high-risk NDMM patients were included in the network meta-analysis. Combination therapies involving novel drugs presented encouraging prospects in the maintenance phase, while the patients and circumstances for the application of different regimens still needed to be further distinguished and clarified. To investigate the current status of maintenance therapy of high-risk NDMM patients in clinical practice, a real-world cohort of high-risk NDMM was retrospectively incorporated 80 patients with lenalidomide maintenance and 53 patients with bortezomib maintenance, presenting the median PFS of 31.7 months and 30.4 months, respectively (p = 0.874, HR = 0.966, 95% CI: 0.628-1.486). Collectively, this study illuminated the present constraints of conventional approaches during the maintenance phase for high-risk NDMM patients while highlighting the future potential associated with enhanced regimens integrating novel medications.
摘要：
尽管新型治疗方法的显著进步延长了多发性骨髓瘤（MM）患者的生存期，细胞遗传学高危新诊断MM(NDMM)的不良预后仍然是棘手的,因为对于维持治疗方案的选择缺乏共识.因此,这项研究的目的是检查各种维持治疗对这一组处于危险中的患者的有效性。总的来说,网络荟萃分析中纳入了17项研究，其中包括1937例NDMM高危患者。涉及新药的联合疗法在维持阶段呈现出令人鼓舞的前景。而应用不同方案的患者和情况仍需进一步区分和澄清。探讨临床上高危NDMM患者的维持治疗现状,一个现实世界的高风险NDMM队列回顾性纳入了80例接受来那度胺维持治疗的患者和53例接受硼替佐米维持治疗的患者，显示31.7个月和30.4个月的中位PFS，分别为(p=0.874，HR=0.966，95%CI：0.628-1.486)。总的来说，这项研究阐明了目前常规治疗方法在高危NDMM患者维持阶段的局限性,同时强调了与整合新型药物的强化治疗方案相关的未来潜力.
