Continuous treatment with new agents for newly diagnosed multiple myeloma

Abstract

To examine the role of novel agents such as bortezomib, lenalidomide, and thalidomide as continuous therapy (induction and consolidation/maintenance) in the treatment of newly diagnosed patients with multiple myeloma, we carried out a meta-analysis of randomized-controlled trials. A comprehensive literature search (Medline, Embase, the Cochrane controlled trials register, and the Science Citation Index) was performed. The initial search yielded 849 citations, of which 11 randomized-controlled trials enrolling 4775 patients fulfilled the inclusion criteria. Continuous addition of bortezomib to conventional therapy before and after autologous stem cell transplantation prolonged overall survival significantly: the summary hazard ratio was 0.80, 95% confidence interval [0.64, 0.99] (P=0.04). Continuous therapy with novel agents consistently improved progression-free survival (PFS) compared with therapy with conventional agents alone. For those patients ineligible for a transplant, the summary hazard ratios for PFS were 0.69 [0.56, 0.85] (P<0.001) for continuous thalidomide therapy and 0.47 [0.33, 0.68] (P<0.001) for continuous lenalidomide therapy; for those patients ineligible for a transplant, the summary hazard ratios for PFS were 0.68 [0.59, 0.79] (P<0.001) for continuous thalidomide therapy and 0.72 [0.61, 0.85] (P<0.001) for continuous lenalidomide therapy. In summary, continuous therapy with novel agents improved PFS consistently, and bortezomib may improve the overall survival of patients with newly diagnosed myeloma when it is added to standard transplantation therapy continuously.

Maintenance Therapy With Immunomodulatory Drugs in Multiple Myeloma: A Meta-Analysis and Systematic Review

“…Previously published meta-analyses (13)(14)(15) were also used as references of the data source when appropriate. Two additional authors (YW and WZ) resolved any discrepancies regarding the extraction/calculation of quantitative data.…”

Systematic review and meta-analysis of the efficacy and safety of novel monoclonal antibodies for treatment of relapsed/refractory multiple myeloma

“…It is characterized by the proliferative disorder of plasma cells in the bone marrow with excessive monoclonal protein production [1]. There were approximately 30,330 new cases of multiple myeloma and 12,650 multiple myeloma-related deaths in the United States in 2016 [2].…”

Efficacy and Safety of Novel Agent-Based Therapies for Multiple Myeloma: A Meta-Analysis

“…Multiple myeloma (MM) is a relatively common hematological malignancy characterized by the proliferative disorder of plasma cells in the bone marrow with excessive monoclonal protein production [ 1 ]. Median age at presentation is 66 years [ 2 ].…”

“…Median survival for newly diagnosed MM is about 44.8 months [ 6 ]. MM cannot be cured [ 1 ], but new drugs are available to manage patients with MM.…”