达雷妥尤单抗为基础的多发性骨髓瘤诱导治疗：系统评价和荟萃分析。
Daratumumab-based induction therapy for multiple myeloma: A systematic review and meta-analysis.
机构信息
Department of Haematology Oncology, National University Cancer Institute Singapore, National University Health System Singapore, Singapore.
Department of Radiation Oncology, National University Cancer Institute Singapore, National University Health System Singapore, Singapore.
出版信息
Crit Rev Oncol Hematol. 2021 Mar;159:103211. doi: 10.1016/j.critrevonc.2020.103211. Epub 2020 Dec 30.
This study aims to evaluate the efficacy and safety of Daratumumab-based induction therapy (DBI) in newly diagnosed multiple myeloma (MM). We identified four eligible RCTs including 2735 patients. The primary outcomes of RCTs involving transplant eligible (TEMM) and non-transplant eligible MM (NTEMM) were stringent complete response (sCR) and progression-free survival (PFS) respectively. Meta-analysis was performed using random-effects models. DBI improved sCR rates for standard risk (SR) (OR 1.86, 95 % CI 1.41-2.46) but not HiR (high risk) (OR 0.78, 95 % CI 0.41-1.48) (interaction P = 0.01) TEMM. In NTEMM, DBI improved PFS in SR (HR 0.44, 95 % CI 0.35-0.55) but not HiR patients. (HR 0.81, 95 % CI 0.52-1.27) (interaction P = 0.02). In conclusion, while DBI is efficacious in SR patients, there is insufficient data to support a benefit in HiR-MM.
这项研究旨在评估达雷妥尤单抗为基础的诱导治疗（DBI）在新诊断多发性骨髓瘤（MM）中的疗效和安全性。我们确定了四项符合条件的 RCT，共纳入 2735 例患者。涉及适合移植（TEMM）和不适合移植（NTEMM）MM 的 RCT 的主要结局分别为严格完全缓解（sCR）和无进展生存期（PFS）。使用随机效应模型进行荟萃分析。DBI 提高了标准风险（SR）（OR 1.86，95%CI 1.41-2.46）但不提高高危（HiR）（OR 0.78，95%CI 0.41-1.48）（交互 P=0.01）TEMM 的 sCR 率。在 NTEMM 中，DBI 提高了 SR 患者的 PFS（HR 0.44，95%CI 0.35-0.55）但不提高 HiR 患者的 PFS（HR 0.81，95%CI 0.52-1.27）（交互 P=0.02）。总之，虽然 DBI 在 SR 患者中有效，但对于 HiR-MM，尚无足够数据支持获益。
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