未经证实:尽管近几十年来在创新多发性骨髓瘤(MM)的新药和联合治疗方案方面取得了显著进展,诱导治疗后最合适的维持方案仍有争议且不透明.
UNASSIGNED:我们旨在通过网络荟萃分析确定新诊断的多发性骨髓瘤(NDMM)患者最有效的维持治疗。
未经授权:我们搜索了PubMed,Embase,科克伦图书馆,Scopus,和谷歌学者从成立到四月,2022年。产生二分变体的赔率比(ORs)。主要终点是总生存期(OS)。
未经批准:最终共19项试验,包括11种治疗方法和8337名患者,包括在此分析中。对于操作系统,来那度胺(OR范围为1.61~1.99)和达雷图单抗(OR范围为1.83~2.41)显示优于安慰剂.维持治疗包括来那度胺-卡非佐米(OR范围为3.19至6.95),来那度胺-泼尼松(OR范围为2.62至4.44),硼替佐米-沙利度胺(OR范围为2.48至3.64),达雷妥单抗(OR范围从2.0到2.98),来那度胺(OR范围从1.4到3.19),艾沙佐米(OR范围从1.36到2.05),与安慰剂相比,沙利度胺(OR范围为1.5至1.86)在延长PFS方面具有显着的作用;在有效的治疗方法中,来那度胺-卡非佐米明显优于来那度胺(OR范围为2.18至2.20),达雷妥单抗(OR范围为1.49~2.66)和艾沙唑米(OR范围为2.75~3.57).
未经评估:考虑到OS和PFS,来那度胺-卡非佐米应被推荐为最佳疗法。在临床实践中,这必须与不良事件风险增加和财务负担相权衡。然而,需要更多的正面研究来证实这些发现.
UNASSIGNED: Despite conspicuous advances in innovating novel drugs and combination regimens in multiple myeloma (MM) in recent decades, the most appropriate maintenance regimens after inductive therapy are still controversial and opaque.
UNASSIGNED: We aimed to identify the most effective maintenance treatment for newly diagnosed multiple myeloma (NDMM) patients via network meta-analysis.
UNASSIGNED: We searched PubMed, Embase, Cochrane Library, Scopus, and Google Scholars from inception to April, 2022. Odds ratios (ORs) were generated for dichotomous variants. The primary endpoint was overall survival (OS).
UNASSIGNED: Eventually a total of 19 trials, including 11 treatments and 8337 patients, were included in this analysis. For OS, lenalidomide (OR ranged from 1.61 to 1.99) and daratumumab (OR ranged from 1.83 to 2.41) showed significant efficacy over placebo. Maintenance therapy comprising lenalidomide-carfilzomib (OR ranged from 3.19 to 6.95), lenalidomide-prednisone (OR ranged from 2.62 to 4.44), bortezomib-thalidomide (OR ranged from 2.48 to 3.64), daratumumab (OR ranged from 2.0 to 2.98), lenalidomide (OR ranged from 1.4 to 3.19), ixazomib (OR ranged from 1.36 to 2.05), thalidomide (OR ranged from 1.5 to 1.86) demonstrated significant effects in prolonging PFS compared with placebo; Among the efficient therapies, lenalidomide-carfilzomib was significantly superior to lenalidomide (OR ranged from 2.18 to 2.20), daratumumab (OR ranged from 1.49 to 2.66) and ixazomib (OR ranged from 2.75 to 3.57).
UNASSIGNED: Considering OS and PFS, lenalidomide-carfilzomib should be recommended as the best therapy. In clinical practice, this must be weighed against the increased risk of adverse events and financial burden. However, more head-to-head studies are needed to confirm these findings.