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

Abstract EN

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.