-
Something wrong with this record ?
Maintenance Treatment and Survival in Patients With Myeloma: A Systematic Review and Network Meta-analysis
F. Gay, G. Jackson, L. Rosiñol, SA. Holstein, P. Moreau, S. Spada, F. Davies, JJ. Lahuerta, X. Leleu, S. Bringhen, A. Evangelista, C. Hulin, U. Panzani, DA. Cairns, F. Di Raimondo, M. Macro, AM. Liberati, C. Pawlyn, M. Offidani, A. Spencer, R....
Language English Country United States
Document type Journal Article, Meta-Analysis, Systematic Review
- MeSH
- Clinical Trials, Phase III as Topic MeSH
- Lenalidomide administration & dosage MeSH
- Multiple Myeloma diagnosis drug therapy MeSH
- Disease-Free Survival MeSH
- Antineoplastic Combined Chemotherapy Protocols therapeutic use MeSH
- Randomized Controlled Trials as Topic MeSH
- Network Meta-Analysis as Topic MeSH
- Maintenance Chemotherapy methods MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
- Systematic Review MeSH
Importance: Several trials demonstrated the impact of novel agent-based maintenance in newly diagnosed multiple myeloma (NDMM), but there is no current evidence demonstrating the superiority of one regimen over the other, owing to the lack of direct/indirect comparisons. Objective: To analyze and compare the effectiveness of different maintenance regimens in NDMM via a network meta-analysis. Data Sources: We performed 2 independent searches in PubMed and Cochrane databases, and then we identified all the records registered after 1999 and on or before November 20, 2017. Study Selection: By blinded review, we identified prospective phase 3 randomized trials evaluating novel agent-based maintenance in patients with NDMM; the included studies compared at least 2 maintenance approaches; comparators included placebo and no maintenance. From 364 screened records, 11 studies were included. Data Extraction and Synthesis: We followed (independent extraction) the guidelines provided by the PRISMA Report and the EQUATOR Network. The evidence was synthesized using a network meta-analysis (NMA). To allow comparison of all treatments, no maintenance was selected as common comparator and the effect of placebo was assumed to be the same as no treatment. The best option was identified by a Bayesian consistency model based on hazard ratio (HR), 95% credible interval (CrI), probability of being the best treatment (PbBT), and median ranking distribution (MedR). Main Outcomes and Measures: Outcomes of interest were progression-free survival (PFS) and overall survival (OS). Results: Eleven trials and 8 treatments including a total of 5073 participants were included. By PFS analysis, lenalidomide-based regimens (lenalidomide-prednisone, lenalidomide alone) were identified as the most effective options (HR, 0.39 [95% CrI, 0.28-0.53] and 0.47 [95% CrI, 0.39-0.55], respectively; MedR, 1 and 2; overall PbBT, 74%). Four treatments (thalidomide-interferon, thalidomide-bortezomib, bortezomib-prednisone, thalidomide alone) showed an HR in favor of maintenance. By OS analysis, lenalidomide alone was identified as the best option (HR, 0.76; 95% CrI, 0.51-1.16; MedR, 2; PbBT, 38%), followed by bortezomib-thalidomide and bortezomib-prednisone. Similar features were noticed in the restricted network including transplant trials, in the sensitivity analysis, and in most of the prognostic subgroups. Conclusions and Relevance: Based on PFS and OS results of this NMA, lenalidomide maintenance appears to be the best treatment option, by synthesizing the available evidence of novel agent-based maintenance in the past 20 years.
Clinica di Ematologia AOU Ospedali Riuniti di Ancona Ancona Italy
Clínica Universidad de Navarra CIMA IDISNA CIBERONC Pamplona Spain
Department of Haematology Alfred Health Monash University Melbourne Australia
Department of Hematology Erasmus Medical Center Rotterdam the Netherlands
Department of Hematology Institut Universitaire du Cancer Toulouse Oncopole Toulouse France
Department of Internal Medicine University of Nebraska Medical Center Omaha
Division of Hematology AOU Policlinico OVE University of Catania Catania Italy
Hématologie and Inserm CIC 1082 Poitiers France
Hematology Department IDIBAPS Hospital Clinic Barcelona Spain
Hematology Department University Hospital Hôtel Dieu Nantes France
Hospital Universitario 12 de Octubre Madrid Spain PETHEMA Grupo Español de Mieloma
Newcastle upon Tyne Hospitals Trust United Kingdom
Service d'Hématologie Hôpital Haut Lévêque CHU Bordeaux 33600 Pessac France
The Institute of Cancer Research London United Kingdom
The Myeloma Institute University of Arkansas for Medical Sciences Little Rock
University Hospital of Salamanca Instituto de Investigación Biomédica de Salamanca Salamanca Spain
References provided by Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc19045311
- 003
- CZ-PrNML
- 005
- 20200114152911.0
- 007
- ta
- 008
- 200109s2018 xxu f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1001/jamaoncol.2018.2961 $2 doi
- 035 __
- $a (PubMed)30098165
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a xxu
- 100 1_
- $a Gay, Francesca $u Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
- 245 10
- $a Maintenance Treatment and Survival in Patients With Myeloma: A Systematic Review and Network Meta-analysis / $c F. Gay, G. Jackson, L. Rosiñol, SA. Holstein, P. Moreau, S. Spada, F. Davies, JJ. Lahuerta, X. Leleu, S. Bringhen, A. Evangelista, C. Hulin, U. Panzani, DA. Cairns, F. Di Raimondo, M. Macro, AM. Liberati, C. Pawlyn, M. Offidani, A. Spencer, R. Hájek, E. Terpos, GJ. Morgan, J. Bladé, P. Sonneveld, J. San-Miguel, PL. McCarthy, H. Ludwig, M. Boccadoro, MV. Mateos, M. Attal,
- 520 9_
- $a Importance: Several trials demonstrated the impact of novel agent-based maintenance in newly diagnosed multiple myeloma (NDMM), but there is no current evidence demonstrating the superiority of one regimen over the other, owing to the lack of direct/indirect comparisons. Objective: To analyze and compare the effectiveness of different maintenance regimens in NDMM via a network meta-analysis. Data Sources: We performed 2 independent searches in PubMed and Cochrane databases, and then we identified all the records registered after 1999 and on or before November 20, 2017. Study Selection: By blinded review, we identified prospective phase 3 randomized trials evaluating novel agent-based maintenance in patients with NDMM; the included studies compared at least 2 maintenance approaches; comparators included placebo and no maintenance. From 364 screened records, 11 studies were included. Data Extraction and Synthesis: We followed (independent extraction) the guidelines provided by the PRISMA Report and the EQUATOR Network. The evidence was synthesized using a network meta-analysis (NMA). To allow comparison of all treatments, no maintenance was selected as common comparator and the effect of placebo was assumed to be the same as no treatment. The best option was identified by a Bayesian consistency model based on hazard ratio (HR), 95% credible interval (CrI), probability of being the best treatment (PbBT), and median ranking distribution (MedR). Main Outcomes and Measures: Outcomes of interest were progression-free survival (PFS) and overall survival (OS). Results: Eleven trials and 8 treatments including a total of 5073 participants were included. By PFS analysis, lenalidomide-based regimens (lenalidomide-prednisone, lenalidomide alone) were identified as the most effective options (HR, 0.39 [95% CrI, 0.28-0.53] and 0.47 [95% CrI, 0.39-0.55], respectively; MedR, 1 and 2; overall PbBT, 74%). Four treatments (thalidomide-interferon, thalidomide-bortezomib, bortezomib-prednisone, thalidomide alone) showed an HR in favor of maintenance. By OS analysis, lenalidomide alone was identified as the best option (HR, 0.76; 95% CrI, 0.51-1.16; MedR, 2; PbBT, 38%), followed by bortezomib-thalidomide and bortezomib-prednisone. Similar features were noticed in the restricted network including transplant trials, in the sensitivity analysis, and in most of the prognostic subgroups. Conclusions and Relevance: Based on PFS and OS results of this NMA, lenalidomide maintenance appears to be the best treatment option, by synthesizing the available evidence of novel agent-based maintenance in the past 20 years.
- 650 _2
- $a protokoly protinádorové kombinované chemoterapie $x terapeutické užití $7 D000971
- 650 _2
- $a klinické zkoušky, fáze III jako téma $7 D017326
- 650 _2
- $a přežití bez známek nemoci $7 D018572
- 650 _2
- $a lenalidomid $x aplikace a dávkování $7 D000077269
- 650 _2
- $a udržovací chemoterapie $x metody $7 D060046
- 650 _2
- $a mnohočetný myelom $x diagnóza $x farmakoterapie $7 D009101
- 650 _2
- $a síťová metaanalýza $7 D000071076
- 650 _2
- $a randomizované kontrolované studie jako téma $7 D016032
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a metaanalýza $7 D017418
- 655 _2
- $a systematický přehled $7 D000078182
- 700 1_
- $a Jackson, Graham $u Newcastle upon Tyne Hospitals Trust, United Kingdom.
- 700 1_
- $a Rosiñol, Laura $u Hematology Department, IDIBAPS, Hospital Clinic, Barcelona, Spain.
- 700 1_
- $a Holstein, Sarah A $u Department of Internal Medicine, University of Nebraska Medical Center, Omaha.
- 700 1_
- $a Moreau, Philippe $u Hematology Department, University Hospital Hôtel-Dieu, Nantes, France.
- 700 1_
- $a Spada, Stefano $u Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
- 700 1_
- $a Davies, Faith $u The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock.
- 700 1_
- $a Lahuerta, Juan José $u Hospital Universitario 12 de Octubre, Madrid, Spain. PETHEMA/Grupo Español de Mieloma.
- 700 1_
- $a Leleu, Xavier $u Hématologie and Inserm CIC 1082, Poitiers, France.
- 700 1_
- $a Bringhen, Sara $u Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
- 700 1_
- $a Evangelista, Andrea $u Unit of Clinical Epidemiology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino and CPO Piemonte, Torino, Italy.
- 700 1_
- $a Hulin, Cyrille $u Service d'Hématologie, Hôpital Haut-Lévêque, CHU Bordeaux, 33600 Pessac, France.
- 700 1_
- $a Panzani, Ugo $u Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
- 700 1_
- $a Cairns, David A $u Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom.
- 700 1_
- $a Di Raimondo, Francesco $u Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy.
- 700 1_
- $a Macro, Margaret $u Institut d'Hématologie de Basse Normandie, University Hospital of Caen, Côte de Nacre, 14033 Caen Cedex 9, France.
- 700 1_
- $a Liberati, Anna Marina $u Università degli Studi di Perugia, Struttura Complessa Universitaria Oncoematologia - Azienda Ospedaliera Santa Maria di Terni, Italy.
- 700 1_
- $a Pawlyn, Charlotte $u The Institute of Cancer Research, London, United Kingdom.
- 700 1_
- $a Offidani, Massimo $u Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy.
- 700 1_
- $a Spencer, Andrew $u Department of Haematology, Alfred Health-Monash University, Melbourne, Australia.
- 700 1_
- $a Hájek, Roman $u Department of Haematooncology, University Hospital Ostrava, Czech Republic and Faculty of Medicine, University of Ostrava, Czech Republic.
- 700 1_
- $a Terpos, Evangelos $u Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
- 700 1_
- $a Morgan, Gareth J $u The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock.
- 700 1_
- $a Bladé, Joan $u Hematology Department, IDIBAPS, Hospital Clinic, Barcelona, Spain. Hematology Department, IDIBAPS, Hospital Clinic, Barcelona, Spain.
- 700 1_
- $a Sonneveld, Pieter $u Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands.
- 700 1_
- $a San-Miguel, Jesús $u Clínica Universidad de Navarra-CIMA, IDISNA, CIBERONC, Pamplona, Spain.
- 700 1_
- $a McCarthy, Philip L $u Blood and Marrow Transplant Program, Department of Medicine, Roswell Park Comprehensive Cancer Center, State University at Buffalo, Buffalo, New York.
- 700 1_
- $a Ludwig, Heinz $u Wilhelminen Cancer Research Institute, Vienna, Austria.
- 700 1_
- $a Boccadoro, Mario $u Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
- 700 1_
- $a Mateos, Maria-Victoria $u University Hospital of Salamanca-Instituto de Investigación Biomédica de Salamanca, Salamanca, Spain.
- 700 1_
- $a Attal, Michel $u Department of Hematology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France.
- 773 0_
- $w MED00186178 $t JAMA oncology $x 2374-2445 $g Roč. 4, č. 10 (2018), s. 1389-1397
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/30098165 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y a $z 0
- 990 __
- $a 20200109 $b ABA008
- 991 __
- $a 20200114153244 $b ABA008
- 999 __
- $a ok $b bmc $g 1483580 $s 1083984
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2018 $b 4 $c 10 $d 1389-1397 $e 20181001 $i 2374-2445 $m JAMA oncology $n JAMA Oncol $x MED00186178
- LZP __
- $a Pubmed-20200109
