Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, #37 Guo Xue Xiang Street, Chengdu, 610041, China.
Sichuan University, Chengdu, China.
Clin Exp Med. 2024 Aug 6;24(1):179. doi: 10.1007/s10238-024-01445-6.
Although the significant strides in novel therapeutic approaches have prolonged the survival of multiple myeloma (MM) patients, the unfavorable prognosis of cytogenetically high-risk newly diagnosed MM (NDMM) remains intractable with the lack of consensus regarding the choice of maintenance regimens. Therefore, this study was initiated with the aim of examining the effectiveness of various maintenance treatments for this group of patients in jeopardy. Overall, 17 studies with 1937 high-risk NDMM patients were included in the network meta-analysis. Combination therapies involving novel drugs presented encouraging prospects in the maintenance phase, while the patients and circumstances for the application of different regimens still needed to be further distinguished and clarified. To investigate the current status of maintenance therapy of high-risk NDMM patients in clinical practice, a real-world cohort of high-risk NDMM was retrospectively incorporated 80 patients with lenalidomide maintenance and 53 patients with bortezomib maintenance, presenting the median PFS of 31.7 months and 30.4 months, respectively (p = 0.874, HR = 0.966, 95% CI: 0.628-1.486). Collectively, this study illuminated the present constraints of conventional approaches during the maintenance phase for high-risk NDMM patients while highlighting the future potential associated with enhanced regimens integrating novel medications.
虽然新型治疗方法的显著进展延长了多发性骨髓瘤（MM）患者的生存时间，但细胞遗传学高危初诊 MM（NDMM）的不良预后仍然难以处理，对于维持治疗方案的选择缺乏共识。因此，本研究旨在探讨各种维持治疗方法对这组高危患者的有效性。总体而言，纳入了 17 项研究，共涉及 1937 例高危 NDMM 患者。在维持阶段，包含新型药物的联合疗法展现出了令人鼓舞的前景，而不同方案的应用患者和情况仍需进一步区分和阐明。为了研究高危 NDMM 患者在临床实践中的维持治疗现状，回顾性纳入了一个高危 NDMM 的真实世界队列，包括 80 例接受来那度胺维持治疗和 53 例接受硼替佐米维持治疗的患者，中位 PFS 分别为 31.7 个月和 30.4 个月（p=0.874，HR=0.966，95%CI：0.628-1.486）。总的来说，这项研究阐明了高危 NDMM 患者在维持阶段常规方法的现有局限性，同时突出了新型药物强化方案的未来潜力。
