在多发性骨髓瘤中,列纳利多米德,伊克萨佐米布或达拉图穆马布作为维持疗法
Eunice Lai1, Yu Yang Soon2, Ainsley Ryan Yan Bin Lee3
1Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore.
列纳利多米德和达拉图穆马布在新诊断的多发性骨髓瘤 (NDMM) 维持治疗中改善了无进展的生存率. 尽管存在风险,但建议使用莱纳利多米德,因为没有任何药物改善了整体存活率.
科学领域:
- 血液学 血液学 血液学
- 临床瘤学临床瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 新诊断的多发性骨髓瘤 (NDMM) 治疗通常涉及维持疗法以延长缓解期.
- 列纳利多米德,伊克萨佐米布和达拉图穆马布是NDMM维护方案.
- 缺乏直接的比较试验.
研究的目的:
- 为了比较lenalidomide,ixazomib和daratumumab作为NDMM的维持疗法的疗效和安全性.
- 评估它们对无进展生存 (PFS) 和整体生存 (OS) 的影响.
主要方法:
- 随机对照试验 (RCT) 的贝叶斯网络元分析 (NMA).
- 包括9个RCT,包括4115名移植资格和1689名非移植资格的MM患者.
- 评估了对PFS和OS的相对治疗效应.
主要成果:
- 列纳利多米德和达拉图穆马布在移植和非移植NDMM中显著改善了PFS与安慰剂相比.
- 伊克萨佐米布没有显示出显著的PFS益处.
- 没有任何药物在高风险细胞遗传学中显示出显著的OS益处或益处.
- 不良事件包括第二次恶性瘤 (莱纳利多米德),血小板缺血 (ixazomib) 和肺炎 (daratumumab).
结论:
- 由于PFS的好处,列纳利多米德被提议作为NDMM的首选维持疗法.
- 可能需要进一步的研究来澄清长期的OS益处和在特定患者子组的最佳使用.
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