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Thalidomide-based Regimens for Elderly and/or Transplant Ineligible Patients with Multiple Myeloma: A Meta-analysis
Alternative TitleThalidomide-based Regimens for Elderly and/or Transplant Ineligible Patients with Multiple Myeloma:A Meta-analysis
Lyu WenWen1; Zhao QingChun2; Song DeHai1; Zhang JinJie1; Ding ZhaoXing1; Li BaoYuan1; Wei ChuanMei1
2016
Source PublicationChinese Medical Journal
ISSN0366-6999
Volume129Issue:3Pages:320-325
AbstractBackground: Thalidomide is an immunomodulatory and anti-angiogenic drug that has shown promise in patients with myeloma. Trials comparing efficacy of standard melphalan and prednisone (MP) therapy with MP plus thalidomide (MPT) in transplant-ineligible or elderly patients with multiple myeloma (MM) have provided conflicting evidence. This meta-analysis aimed to determine the efficacy and toxicity of thalidomide in previously untreated elderly patients with myeloma. Methods: Medline, the Cochrane Controlled Trials register, conference proceedings of the American Society of Hematology (1995–2014), the American Society of Clinical Oncology (1995–2014), and CBM, VIP, and CNKI databases were searched for randomized control trials with the use of the medical subject headings “MM “ and “thalidomide “. Trials were assessed by two reviewers for eligibility. Meta-analysis was conducted using a fixed effects model. Sensitivity analysis was performed to test the robustness of the findings. Results: Overall, seven trials were identified, covering a total of 1821 subjects. The summary hazard ratio (thalidomide vs. control) was 0.82 (95% confidence interval CI: 0.72–0.94) for overall survival (OS), and 0.65 (95% CI: 0.58–0.73) for progression-free survival, in favor of thalidomide treated group. The risk ratio of complete response with induction thalidomide was 3.48 (95% CI: 2.24–5.41). A higher rate of III/IV adverse events were observed in MPT arm compared with the MP arm. However, analysis of sub-groups administering anticoagulation as venous thromboembolism prophylaxis suggested no difference in relative risk of thrombotic events between two arms (RR = 1.47, 95% CI: 0.43–5.07, P = 0.54). Further analysis of trials on the treatment effects of MPT versus MP on adverse events-related mortality showed no statistical difference between two arms (RR = 1.24, 95% CI: 0.95–1.63
Other AbstractBackground:Thalidomide is an immunomodulatory and anti-angiogenic drug that has shown promise in patients with myeloma. Trials comparing efficacy of standard melphalan and prednisone (MP) therapy with MP plus thalidomide (MPT) in transplant-ineligible or elderly patients with multiple myeloma (MM) have provided conflicting evidence. This meta-analysis aimed to determine the efficacy and toxicity of thalidomide in previously untreated elderly patients with myeloma. Methods:Medline, the Cochrane Controlled Trials register, conference proceedings of the American Society of Hematology (1995-2014), the American Society of Clinical Oncology (1995-2014), and CBM, VIP, and CNKI databases were searched for randomized control trials with the use of the medical subject headings "MM" and "thalidomide". Trials were assessed by two reviewers for eligibility. Meta-analysis was conducted using a fixed effects model. Sensitivity analysis was performed to test the robustness of the findings. Results:Overall, seven trials were identified, covering a total of 1821 subjects. The summary hazard ratio (thalidomide vs. control) was 0.82 (95% confidence interval CI:0.72-0.94) for overall survival (OS), and 0.65 (95% CI:0.58-0.73) for progression-free survival, in favor of thalidomide treated group. The risk ratio of complete response with induction thalidomide was 3.48 (95% CI:2.24-5.41). A higher rate of III/IV adverse events were observed in MPT arm compared with the MP arm. However, analysis of sub-groups administering anticoagulation as venous thromboembolism prophylaxis suggested no difference in relative risk of thrombotic events between two arms (RR = 1.47, 95% CI:0.43-5.07, P =0.54). Further analysis of trials on the treatment effects of MPT versus MP on adverse events-related mortality showed no statistical difference between two arms (RR = 1.24, 95% CI:0.95-1.63
KeywordElderly Medicine R Meta-analysis Multiple Myeloma Thalidomide
Indexed ByCSCD
Language英语
CSCD IDCSCD:5625639
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Document Type期刊论文
Identifierhttp://ir.imr.ac.cn/handle/321006/145214
Collection中国科学院金属研究所
Affiliation1.Binzhou Med University Hosp, Dept Pharm, Binzhou 256603, Shandong, Peoples R China
2.中国科学院金属研究所
Recommended Citation
GB/T 7714
Lyu WenWen,Zhao QingChun,Song DeHai,et al. Thalidomide-based Regimens for Elderly and/or Transplant Ineligible Patients with Multiple Myeloma: A Meta-analysis[J]. Chinese Medical Journal,2016,129(3):320-325.
APA Lyu WenWen.,Zhao QingChun.,Song DeHai.,Zhang JinJie.,Ding ZhaoXing.,...&Wei ChuanMei.(2016).Thalidomide-based Regimens for Elderly and/or Transplant Ineligible Patients with Multiple Myeloma: A Meta-analysis.Chinese Medical Journal,129(3),320-325.
MLA Lyu WenWen,et al."Thalidomide-based Regimens for Elderly and/or Transplant Ineligible Patients with Multiple Myeloma: A Meta-analysis".Chinese Medical Journal 129.3(2016):320-325.
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