基于 Venetoclax 的方案在复发或难治性多发性骨髓瘤中的疗效和安全性：前瞻性临床试验的系统评价和荟萃分析。
Efficacy and safety of Venetoclax-based regimens in relapsed or refractory multiple myeloma: a systematic review and meta-analysis of prospective clinical trials.
机构信息
Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, People's Republic of China.
出版信息
Ann Med. 2023 Dec;55(1):1029-1036. doi: 10.1080/07853890.2023.2186480.
BACKGROUND
Multiple myeloma (MM) is an incurable malignancy. Venetoclax (VEN) shows a meaningful effect in MM patients who are relapsed or refractory (RR) to previous standard therapies.
OBJECTIVE
This study aimed to assess the efficacy and safety of VEN-based treatments in RR MM patients.
MATERIALS AND METHODS
Comprehensive studies were searched in PubMed, Embase, Web of Science and Cochrane library. Efficacy was assessed by overall response rate (ORR), strict complete response rate (sCR), complete response rate (CR), very good partial response rate (VGPR) and partial response rate (PR).
RESULTS
Seven studies containing 482 subjests were included. The pooled ORR, ≥ CR (sCR + CR), VGPR and PR were 68% (51%-85%), 24% (13%-35%), 25% (17%-34%) and 17% (11%-24%) respectively. Multi-drug treatments were superior to VEN ± dexamethasone (Dex) treatments in ORR (82% vs 42%, = .003) and ≥ CR (36% vs 7%, < 0.00001). Subgroup analysis indicated patients achieve higher ORR who harboring t(11;14) translocation or containing high BCL-2 expression.
CONCLUSIONS
VEN-containing regimens could be suggested as effective and safe treatments to RR MM patients with t(11;14) or high BCL-2 levels.
背景
多发性骨髓瘤（MM）是一种无法治愈的恶性肿瘤。维奈托克（VEN）在先前标准治疗复发或难治性（RR）的 MM 患者中显示出有意义的疗效。
目的
本研究旨在评估 VEN 为基础的治疗方案在 RR MM 患者中的疗效和安全性。
材料和方法
在 PubMed、Embase、Web of Science 和 Cochrane 图书馆中进行全面检索。通过总缓解率（ORR）、严格完全缓解率（sCR）、完全缓解率（CR）、非常好的部分缓解率（VGPR）和部分缓解率（PR）来评估疗效。
结果
纳入了 7 项包含 482 例受试者的研究。汇总的 ORR、≥CR（sCR+CR）、VGPR 和 PR 分别为 68%（51%-85%）、24%（13%-35%）、25%（17%-34%）和 17%（11%-24%）。多药治疗在 ORR（82% vs 42%，=0.003）和≥CR（36% vs 7%，<0.00001）方面优于 VEN±地塞米松（Dex）治疗。亚组分析表明，携带 t（11；14）易位或高 BCL-2 表达的患者 ORR 更高。
结论
对于携带 t（11；14）易位或高 BCL-2 水平的 RR MM 患者，含 VEN 的方案可作为有效且安全的治疗选择。
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