Triplet versus doublet combination regimens for the treatment of relapsed or refractory multiple myeloma: A meta-analysis of phase III randomized controlled trials.
Crit Rev Oncol Hematol
; 113: 249-255, 2017 May.
Article
en En
| MEDLINE
| ID: mdl-28427514
ABSTRACT
During the past decades, several prospective trials had been conducted to assess the efficacy and toxicities of triplet versus doublet combination regimens for the treatment of relapsed or refractory multiple myeloma (RRMM), but the results were controversial. We thus performed a systematic literature search to identify relevant trials. Summary hazard ratios (HRs), relative risks (RRs), and 95% confidence intervals (95%CIs) were calculated. A total of 3197 RRMM patients were included for analysis. The pooled results demonstrated that triplet combination therapies significantly improve OS (HR 0.83, 95%CI 0.71-0.94, p=0.004) and PFS (HR 0.68, 95%CI 0.62-0.74, p<0.001). The pooled RRs of ORR, very good partial response (VGPR) and complete response (CR) with triplets vs. doublets were 1.19 (95%CI 1.10-1.27), 1.44 (95%CI 1.18-1.77), and 1.76 (95%CI 1.04-2.97), respectively, indicating that the RRs of achieving deeper responses were higher with triplets, though the RRs of overall≥grade 3 adverse events (RR 1.11, p=0.001) and ≥grade 3 thrombocytopenia (RR 1.64, p=0.009) was higher with triplets. In conclusion, our meta-analysis demonstrated that triplet regimens result in improved OS, PFS, ORR, VGPR, and CR when compared to doublets, though the risk of grade 3 and 4 adverse events were higher with triplets.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
/
Mieloma Múltiple
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Crit Rev Oncol Hematol
Asunto de la revista:
HEMATOLOGIA
/
NEOPLASIAS
Año:
2017
Tipo del documento:
Article