Efficacy of proteasome inhibitor-based maintenance following autologous transplantation in multiple myeloma: A systematic review and meta-analysis

被引：3

作者：

Parrondo, Ricardo D. ^{[1
,2
]}

Reljic, Tea ^{[3
]}

Iqbal, Madiha ^{[1
,2
]}

Ayala, Ernesto ^{[1
,2
]}

Kharfan-Dabaja, Mohamed A. ^{[1
,2
]}

Kumar, Ambuj ^{[3
]}

Murthy, Hemant S. ^{[1
,2
]}

机构：

[1] Mayo Clin, Div Hematol Oncol, Jacksonville, FL 32224 USA

[2] Mayo Clin, Blood & Marrow Transplantat Program, Jacksonville, FL 32224 USA

[3] Univ S Florida, Morsani Coll Med, Program Comparat Effectiveness Res, Tampa, FL 33620 USA

来源：

EUROPEAN JOURNAL OF HAEMATOLOGY | 2021年 / 106卷 / 01期

关键词：

autologous hematopoietic cell transplantation; maintenance therapy; multiple myeloma; proteasome inhibitors; STEM-CELL TRANSPLANTATION; LENALIDOMIDE MAINTENANCE; PLUS DEXAMETHASONE; DOUBLE-BLIND; BORTEZOMIB; THERAPY; THALIDOMIDE; INDUCTION; OUTCOMES; PHASE-3;

D O I：

10.1111/ejh.13506

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction Lenalidomide maintenance, commonly prescribed in the postautologous transplantation (AHCT) setting for multiple myeloma (MM), is associated with development of secondary primary malignancies (SPM). Proteasome inhibitor maintenance (PIM) has also been evaluated in MM. We conduct a systematic review/meta-analysis to assess the efficacy of PIM in MM. Methods Performing a comprehensive search of the medical literature using PubMed/Medline and EMBASE on September 11, 2019, we extracted data on clinical outcomes related to benefits (OS, PFS, and depth of hematologic response [DOHR]) and harms (SPM and adverse events). 2144 references were identified; three studies were eligible for inclusion. Results A total of 1760 patients were included in the analysis; 507 patients received bortezomib and 395 received ixazomib maintenance. Control arms were either placebo (n = 261) or thalidomide (n = 358). PIM did not improve OS (HR 0.88, 95% CI 0.73-1.05,P = .15) but improved PFS (HR 0.77, 95% CI 0.69-0.86,P <= .00001) and DOHR (HR 0.88, 95% CI 0.79-0.98,P = .02) compared with control. There were no significant differences between PIM and control regarding SPM (p = NS) and >= grade 3 peripheral neuropathy (PN) (p = NS). Conclusions PIM following AHCT in MM improves PFS and DOHR without an increase in development of SPM or severe PN compared with placebo/thalidomide.

引用

页码：40 / 48

页数：9

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