The efficacy and safety of triplet regimens based on pomalidomide and dexamethasone for treatment of relapsed/refractory multiple myeloma: a systematic review and meta-analysis
机构:[1]Department of Hematology, Stem Cell Laboratory, Clinical Research Institute, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China. huangchunlan@swmu.edu.cn.
Triplet regimens based on pomalidomide and dexamethasone have been applied to treat relapsed/refractory multiple myeloma, but the safety and efficacy are not yet very clear. This meta-analysis aimed at comparing the safety and efficacy of different triplet therapies and analyzing the best therapy regimen.A comprehensive literature search identified a total of 615 studies, and 22 studies assessing 1,889 subjects met the inclusion criteria of this meta: phase II/III trial, over 2 median lines of prior therapy, and detailed efficacy outcomes like overall response rate (ORR), overall survival, and progression-free survival (PFS). All statistical analyses were performed by Revman version 5.3, and the heterogeneity was tested by I2 (25% indicating low heterogeneity, 50% moderate, and 75% high). For those with less heterogeneity, fixed-effect model was used. With a significant high heterogeneity, a random-effect model was used.Pooled analysis showed ORR 66.2% across all triplet regimens based on pomalidomide and dexamethasone. Among all triplet regimens, therapy containing bortezomib showed the highest ORR (90.3%), and the one containing elotuzumab showed the lowest ORR (41.2%). The pooled ORRs for the remaining treatment regimens are as follows: cyclophosphamide (70.1%), isatuximab (66.3%), daratumumab (61.2%), clarithromycin (60.0%), pembrolizumab (47.3%). A total of 21 adverse events appeared in the included studies, with neutropenia being the highest incidence of hematologic adverse events (32.1%) and cough being the highest incidence of non-hematologic adverse events (43.3.%).Three-drug regimens based on pomalidomide and dexamethasone could yield excellent overall response rate to relapsed/refractory multiple myeloma, but there are still various adverse events; therefore, consequent studies should address these adverse events.
基金:
This study was supported by Sichuan department of science and technology (grant No. 20YYJC0940) and Luzhou
people’s government-Southwest Medical University joint
project (grant No. 2017LZXNYD-Z06).
语种:
外文
PubmedID:
中科院(CAS)分区:
出版当年[2022]版:
大类|4 区医学
小类|4 区药学
最新[2023]版:
大类|4 区医学
小类|4 区药学
第一作者:
第一作者机构:[1]Department of Hematology, Stem Cell Laboratory, Clinical Research Institute, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China. huangchunlan@swmu.edu.cn.
共同第一作者:
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推荐引用方式(GB/T 7714):
Liao K-Y,Liu Y,Xiong H,et al.The efficacy and safety of triplet regimens based on pomalidomide and dexamethasone for treatment of relapsed/refractory multiple myeloma: a systematic review and meta-analysis[J].European review for medical and pharmacological sciences.2022,26(21):8087-8097.doi:10.26355/eurrev_202211_30162.
APA:
Liao K-Y,Liu Y,Xiong H,Chen X-M,Zhang X-W&Huang C-L.(2022).The efficacy and safety of triplet regimens based on pomalidomide and dexamethasone for treatment of relapsed/refractory multiple myeloma: a systematic review and meta-analysis.European review for medical and pharmacological sciences,26,(21)
MLA:
Liao K-Y,et al."The efficacy and safety of triplet regimens based on pomalidomide and dexamethasone for treatment of relapsed/refractory multiple myeloma: a systematic review and meta-analysis".European review for medical and pharmacological sciences 26..21(2022):8087-8097