Frontline Therapy for Multiple Myeloma: A Concise Review of the Evidence Based on Randomized Clinical Trials

Yaqub, Sobia; Ballester, Gabriela; Ballester, Oscar F.

doi:10.3109/07357907.2013.840382

Cited by 9 publications

(5 citation statements)

References 70 publications

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“…Despite the AEs of novel agents in the present meta-analysis, there were clear advantages in terms of benefits and safety in the treatment of patients with MM using novel agent-based regimens like bortezomib, thalidomide, and lenalidomide, as previously recommended [ 52 ]. Novel agent-based therapy should be considered as promising induction regimens for patients with previously untreated MM.…”

Section: Discussionmentioning

confidence: 96%

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

Wang

Yan

2016

BioMed Research International

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This study aimed at comparing bortezomib, thalidomide, and lenalidomide in patients with multiple myeloma (MM) for safety and efficacy using meta-analysis. This meta-analysis identified 17 randomized controlled trials (RCTs) including 6742 patients. These RCTs were separated according to the different agent-based regimens and to autologous stem-cell transplantation (ASCT). Complete response (CR), progression-free survival (PFS), overall survival (OS), and adverse events (AE) were combined. The total weighted risk ratio (RR) of CR was 3.29 [95% confidence interval (95% CI): 2.22–4.88] (P < 0.0001) for the novel agent-based regimens. These novel agent-based regimens showed greater benefit in terms of PFS of all subgroups irrespective of whether the patient received ASCT or not. The hazard ratio (HR) for PFS was 0.64 [95% CI: 0.60–0.69] (P < 0.00001). Improvements of OS could be found only in the bortezomib- and thalidomide-based regimens without ASCT. The pooled HRs were 0.74 [95% CI: 0.65–0.86] (P < 0.0001) and 0.80 [95% CI: 0.70–0.90] (P = 0.0004), respectively. Several AEs were shown more frequently in the novel agent-based regimens compared with controls such as hematologic events (neutropenia, anemia, and thrombocytopenia), gastrointestinal infection, peripheral neuropathy, thrombosis, and embolism events. In conclusion, in spite of the AEs, novel agent-based regimens are safe and effective for the treatment of MM.

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Section: Discussionmentioning

confidence: 96%

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

Wang

Yan

2016

BioMed Research International

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“…Epigenetic dysregulation plays an important role in the progression of MM (9). Abnormal methylation and the overproduction of misfolded proteins have been widely observed in MM tissues and cells (10,11). For example, histone deacetylase (HDAC) inhibitors have become a focus of research in the treatment of MM (12).…”

Section: Introductionmentioning

confidence: 99%

JMJD2C triggers the growth of multiple myeloma cells via activation of β‑catenin

Liu

2021

Oncol Rep

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Emerging evidence has indicated that histone modification and its related regulators are involved in the progression of multiple myeloma (MM) cells. In the present study, the expression of Jumonji C domain-containing 2 (JMJD2) was examined in both MM tissues and healthy controls. The roles of JMJD2C in the progression of MM were further investigated. The results revealed that the expression of JMJD2C, but not that of JMJD2A or JMJD2B, was increased in MM tissues compared with the healthy controls. The overexpression of JMJD2C significantly increased the in vitro growth of MM cells. The inhibitor of the β-catenin signaling pathway significantly attenuated the JMJD2C-induced growth of MM cells. Mechanistical analyses indicated that JMJD2C increased the transcription of β-catenin in MM cells, which may be due to the fact that JMJD2C can directly bind with the promoter of β-catenin. Furthermore, JMJD2C activated β-catenin in MM cells via a GSK3β-dependent manner, which was evidenced by the results demonstrating that the overexpression of GSK3β attenuated the JMJD2C-induced decrease in the phosphorylation of β-catenin. On the whole, the findings of the present study demonstrated that JMJD2C promotes the malignancy of MM via the activation of the β-catenin pathway. These results suggested that JMJD2C may be a potential target for MM treatment.

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“…High-dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT) [1,2] remains the standard of care for young medically fit patients with multiple myeloma (MM) [3][4][5]. Recent studies also suggest that induction therapy with so-called new drugs before transplantation may improve clinical outcomes [6,7].…”

Section: Introductionmentioning

confidence: 99%

Very Low Rate of Readmission after an Early Discharge Outpatient Model for Autografting in Multiple Myeloma Patients: An Italian Multicenter Retrospective Study

Martino¹,

Montanari

Ferrara

et al. 2014

Biology of Blood and Marrow Transplantation

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We analyzed the main modalities and clinical outcomes of the early discharge outpatient model in autologous stem cell transplantation (EDOM-ASCT) for multiple myeloma in Italy. EDOM-ASCT was employed in 382 patients, for a total of 522 procedures, between 1998 and 2012. Our study showed high homogeneity among centers in terms of inclusion criteria, supportive care, and in hospital readmission criteria. Overall, readmissions during the aplastic phase occurred in 98 of 522 transplantations (18.8%). The major extrahematological complication was neutropenic fever in 161 cases (30.8%), which required readmission in 76 cases. The incidence of severe World Health Organization grade 3 to 4 mucositis was 9.6%. By univariate analysis, fever, mucositis, altered renal function at diagnosis, second transplantation, and transplantation performed late in the course of the disease were significantly correlated with readmission, whereas fever, mucositis, altered renal function, and timing of transplantation remained the only independent predictors by multivariate analysis. Overall, transplantation-related mortality was 1.0%. No center effect was observed in this study (P = .36). The safety and low rate of readmission of the EDOM-ASCT in myeloma trial suggest that this strategy could be extended to other transplantation centers if a stringent patient selection and appropriate management are applied.

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Frontline Therapy for Multiple Myeloma: A Concise Review of the Evidence Based on Randomized Clinical Trials

Cited by 9 publications

References 70 publications

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

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

JMJD2C triggers the growth of multiple myeloma cells via activation of β‑catenin

Very Low Rate of Readmission after an Early Discharge Outpatient Model for Autografting in Multiple Myeloma Patients: An Italian Multicenter Retrospective Study

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