Department of Haematology, University Hospital of Ioannina, Ioannina, Greece.
Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Crit Rev Oncol Hematol. 2022 Dec;180:103842. doi: 10.1016/j.critrevonc.2022.103842. Epub 2022 Oct 13.
In this overview we present a summary of evidence from systematic reviews (SRs) on the safety and efficacy of carfilzomib in multiple myeloma (MM). Our search in electronic databases and conference proceedings yielded 14 eligible SRs, graded as of low overall quality with the AMSTAR-2 tool. The Corrected Covered Area index was 52.3% which shows very high overlap among studies. Carfilzomib was shown to increase progression free survival (HR=0.61, 95%CI=0.47-0.78, p = 0.01, I =73%), overall survival (HR=0.79,95%CI=0.66-0.95, p = 0.01, I =0) and overall response rate (OR=2.4,95% CI=1.6-3.4, p < 0.001, I =99%) in relapsed/refractory MM (RRMM); all with moderate quality of evidence assessed with the GRADE approach. Carfilzomib was associated with cardiovascular adverse events (AEs) (RR=2.2, 95%CI=1.6-2.9, p < 0.001, I =0), nephrotoxicity (RR=1.79, 95% CI=1.43-2.23, p < 0.001, I =39%) and serious infections (RR=1.40, 95%CI=1.17-1.69, p < 0.001, I =57%). Concluding, carfilzomib is effective in RRMM, but associated with certain AEs. More randomized clinical trials and high-quality SRs, especially on newly diagnosed patients are needed.
在这篇综述中，我们总结了系统评价（SRs）中关于卡非佐米在多发性骨髓瘤（MM）中的安全性和疗效的证据。我们在电子数据库和会议记录中进行了搜索，共纳入了 14 项符合条件的 SRs，使用 AMSTAR-2 工具评估其整体质量较低。校正的覆盖面积指数为 52.3%，表明研究之间存在高度重叠。卡非佐米可提高无进展生存期（HR=0.61，95%CI=0.47-0.78，p=0.01，I=73%）、总生存期（HR=0.79，95%CI=0.66-0.95，p=0.01，I=0）和总体缓解率（OR=2.4，95%CI=1.6-3.4，p<0.001，I=99%），所有这些都具有中等质量的证据，使用 GRADE 方法进行评估。卡非佐米与心血管不良事件（AE）（RR=2.2，95%CI=1.6-2.9，p<0.001，I=0）、肾毒性（RR=1.79，95%CI=1.43-2.23，p<0.001，I=39%）和严重感染（RR=1.40，95%CI=1.17-1.69，p<0.001，I=57%）相关。结论：卡非佐米在 RRMM 中有效，但与某些 AE 相关。需要更多的随机临床试验和高质量的 SRs，特别是在新诊断的患者中。
