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. 2023 Mar;200(6):694-703.
doi: 10.1111/bjh.18654. Epub 2023 Jan 20.

Relapsed and refractory multiple myeloma: A systematic review and network meta-analysis of the efficacy of novel therapies

Daisuke Minakata  1 , Shin-Ichiro Fujiwara  1   2 , Daizo Yokoyama  1 , Atsuto Noguchi  1 , Shuka Aoe  1 , Takashi Oyama  1 , Shunsuke Koyama  1 , Rui Murahashi  1 , Hirotomo Nakashima  1 , Kazuki Hyodo  1 , Takashi Ikeda  1 , Shin-Ichiro Kawaguchi  1 , Yumiko Toda  1 , Shoko Ito  1 , Takashi Nagayama  1 , Kiyomi Mashima  1 , Kento Umino  1 , Kaoru Morita  1 , Masahiro Ashizawa  1 , Chihiro Yamamoto  1 , Kaoru Hatano  1 , Kazuya Sato  1 , Ken Ohmine  1 , Yoshinobu Kanda  1   3
Affiliations

Relapsed and refractory multiple myeloma: A systematic review and network meta-analysis of the efficacy of novel therapies

Daisuke Minakata et al. Br J Haematol. 2023 Mar.

Abstract

The prognosis of multiple myeloma (MM) has dramatically improved with the development of new drugs, and it has become important to determine the appropriate combinations of these novel agents. This study was a systematic review and network meta-analysis (NMA) of randomized trials in patients with relapsed and/or refractory (RR) MM. The PubMed, Cochrane, and Embase databases were searched for randomized trials from 1 January 2002 to 28 February 2022 of patients treated for MM. The primary end-point was progression-free survival (PFS), evaluated as a hazard ratio (HR) with a 95% confidence interval (95% CI) compared to dexamethasone (DEX). The p-score was used to rank treatments. Of a total of 1136 abstracts screened, 37 studies were selected, including 34 treatment options for RRMM. Daratumumab, lenalidomide and DEX was found to be the best treatment for RRMM, with the best HR compared to DEX (HR, 0.13; 95% CI, 0.08-0.20; p-score 0.9796). There was no evidence of significant heterogeneity (I2 , 41.3%; p = 0.146). The current NMA confirmed the excellent efficacy of three-drug regimens including anti-CD38 antibodies to treat RRMM and provides background data to evaluate the efficacy of chimeric antigen receptor T-cell treatments and bispecific T-cell engager therapies.

Keywords: double-refractory myeloma; high risk myeloma; network meta-analysis; plasma cell malignancy.

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References

REFERENCES

    1. Dimopoulos MA, Moreau P, Terpos E, Zweegman S, Mateos MV, Cook G, et al. Multiple myeloma: EHA-ESMO clinical practice guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2021;32(3):309-22. https://doi.org/10.1016/j.annonc.2020.11.014
    1. Callander NS, Baljevic M, Adekola K, Anderson LD, Campagnaro E, Castillo JJ, et al. NCCN guidelines® insights: multiple myeloma, version 3.2022. J Natl Compr Canc Netw. 2022;20(1):8-19. https://doi.org/10.6004/jnccn.2022.0002
    1. van Beurden-Tan CHY, Franken MG, Blommestein HM, Uyl-de Groot CA, Sonneveld P. Systematic literature review and network meta-analysis of treatment outcomes in relapsed and/or refractory multiple myeloma. J Clin Oncol. 2017;35(12):1312-9. https://doi.org/10.1200/JCO.2016.71.1663
    1. Botta C, Ciliberto D, Rossi M, Staropoli N, Cucè M, Galeano T, et al. Network meta-analysis of randomized trials in multiple myeloma: efficacy and safety in relapsed/refractory patients. Blood Adv. 2017;1(7):455-66. https://doi.org/10.1182/bloodadvances.2016003905
    1. Arcuri LJ, Americo AD. Treatment of relapsed/refractory multiple myeloma in the bortezomib and lenalidomide era: a systematic review and network meta-analysis. Ann Hematol. 2021;100(3):725-34. https://doi.org/10.1007/s00277-021-04404-3

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