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Título
Maintenance Treatment and Survival in Patients with Myeloma: A Systematic Review and Network Meta-analysis
Autor(es)
Palabras clave
Myeloma
Treatment
Continuous therapy
Multiagent chemotherapy
Thalidomide
Peripheral neuropathy
Autologous Stem Cell Transplantation (ASCT)
Clasificación UNESCO
3201.01 Oncología
Fecha de publicación
2018
Editor
American Medical Association
Citación
Gay F, Jackson G, Rosiñol L, et al.(2018) Maintenance Treatment and Survival in Patients With Myeloma: A Systematic Review and Network Meta-analysis. JAMA Oncol. 2018;4(10):1389–1397. doi:10.1001/jamaoncol.2018.2961
Resumen
[EN]To analyze and compare the effectiveness of different maintenance regimens in NDMM via a network meta-analysis. Data Sources: We performed 2 independent searches in PubMed and Cochrane databases, and then we identified all the records registered after 1999 and on or before November 20, 2017. Study Selection: By blinded review, we identified prospective phase 3 randomized trials evaluating novel agent-based maintenance in patients with NDMM; the included studies compared at least 2 maintenance approaches; comparators included placebo and no maintenance. From 364 screened records, 11 studies were included. The evidence was synthesized using a network meta-analysis (NMA). To allow comparison of all treatments, no maintenance was selected as common comparator and the effect of placebo was assumed to be the same as no treatment. Eleven trials and 8 treatments including a total of 5073 participants were included. By PFS analysis, lenalidomide-based regimens (lenalidomide-prednisone, lenalidomide alone) were identified as the most effective options (HR, 0.39 [95% CrI, 0.28-0.53] and 0.47 [95% CrI, 0.39-0.55], respectively; MedR, 1 and 2; overall PbBT, 74%).
URI
ISSN
2374-2437
DOI
10.1001/jamaoncol.2018.2961
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