A Systematic Review and Network Meta-analysis of Randomized Data on Efficacy of Novel Therapy Combinations in Patients with Lenalidomide-refractory Multiple Myeloma.

Clinical Lymphoma, Myeloma & Leukemia
Ghulam Rehman MohyuddinAl-Ola Abdallah

Abstract

Lenalidomide use in nearly all induction regimens for multiple myeloma (MM) has led to the treatment of lenalidomide-refractory disease becoming one of the most important clinical questions in its treatment. Given the lack of direct comparisons of treatment regimens for lenalidomide-refractory MM, we used a systematic review to identify randomized controlled trials (RCTs) that included lenalidomide-refractory subgroup analysis. We performed a systematic review to identify RCTs for MM that enrolled patients with lenalidomide-refractory disease, then performed a network meta-analysis (NMA) using random effects model to compare regimens. We identified 123 discrete RCTs, of which 7 reported primary outcomes for lenalidomide-refractory MM. These were linked in 2 discrete networks totaling 1698 lenalidomide-refractory patients. Network 1 compared bortezomib (bort)/dexamethasone (dex) versus other treatments, and analysis showed triplet therapy with pomalidomide (pom)/bort/dex (hazard ratios [HR] 0.65, 95% confidence interval [CI], 0.50-0.84), daratumumab (dara)/bort/dex (HR 0.36, 95% CI, 0.21-0.63), and dara/carfilzomib (carf)/dex (HR 0.38, 95% CI, 0.21-0.69) as more effective than bort/dex. Network 2 compared dex versus other treatm...Continue Reading

References

Jul 13, 2004·Mayo Clinic Proceedings·Shaji K KumarPhilip R Greipp
Mar 18, 2011·The New England Journal of Medicine·Antonio Palumbo, Kenneth Anderson
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Dec 9, 2014·The New England Journal of Medicine·A Keith StewartUNKNOWN ASPIRE Investigators
Apr 4, 2015·Blood·Ajay K NookaSagar Lonial
Apr 28, 2016·The New England Journal of Medicine·Philippe MoreauUNKNOWN TOURMALINE-MM1 Study Group
Aug 25, 2016·The New England Journal of Medicine·Antonio PalumboUNKNOWN CASTOR Investigators
Oct 6, 2016·The New England Journal of Medicine·Meletios A DimopoulosUNKNOWN POLLUX Investigators
Feb 28, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Chrissy H Y van Beurden-TanPieter Sonneveld
Apr 6, 2017·The New England Journal of Medicine·Michel AttalUNKNOWN IFM 2009 Study
Oct 6, 2017·Research Synthesis Methods·Gerta Rücker, Guido Schwarzer
Nov 8, 2018·The New England Journal of Medicine·Meletios A DimopoulosJesús San-Miguel
Mar 27, 2020·American Journal of Hematology·S Vincent Rajkumar
Jul 1, 2017·Annals of Oncology : Official Journal of the European Society for Medical Oncology·P MoreauUNKNOWN ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org

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