Maintenance therapy for cytogenetically high-risk multiple myeloma: landscape in the era of novel drugs.

IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Xinyuan Gu, Wenjiao Tang, Li Zhang, Yuhuan Zheng, Ling Pan, Ting Niu
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Abstract

Although the significant strides in novel therapeutic approaches have prolonged the survival of multiple myeloma (MM) patients, the unfavorable prognosis of cytogenetically high-risk newly diagnosed MM (NDMM) remains intractable with the lack of consensus regarding the choice of maintenance regimens. Therefore, this study was initiated with the aim of examining the effectiveness of various maintenance treatments for this group of patients in jeopardy. Overall, 17 studies with 1937 high-risk NDMM patients were included in the network meta-analysis. Combination therapies involving novel drugs presented encouraging prospects in the maintenance phase, while the patients and circumstances for the application of different regimens still needed to be further distinguished and clarified. To investigate the current status of maintenance therapy of high-risk NDMM patients in clinical practice, a real-world cohort of high-risk NDMM was retrospectively incorporated 80 patients with lenalidomide maintenance and 53 patients with bortezomib maintenance, presenting the median PFS of 31.7 months and 30.4 months, respectively (p = 0.874, HR = 0.966, 95% CI: 0.628-1.486). Collectively, this study illuminated the present constraints of conventional approaches during the maintenance phase for high-risk NDMM patients while highlighting the future potential associated with enhanced regimens integrating novel medications.

Abstract Image

细胞遗传学高风险多发性骨髓瘤的维持治疗:新药时代的前景。
尽管新型治疗方法取得了长足进步,延长了多发性骨髓瘤(MM)患者的生存期,但细胞遗传学高危新诊断 MM(NDMM)患者的预后仍然不容乐观,在维持治疗方案的选择上也缺乏共识。因此,我们启动了这项研究,旨在考察各种维持治疗方法对这一危重病人群体的疗效。网络荟萃分析共纳入了 17 项研究,涉及 1937 名高风险 NDMM 患者。涉及新型药物的联合疗法在维持治疗阶段的前景令人鼓舞,但仍需进一步区分和明确应用不同疗法的患者和情况。为调查临床实践中高风险NDMM患者的维持治疗现状,我们回顾性纳入了一个真实世界的高风险NDMM队列,其中80例患者接受来那度胺维持治疗,53例患者接受硼替佐米维持治疗,中位PFS分别为31.7个月和30.4个月(P = 0.874,HR = 0.966,95% CI:0.628-1.486)。总之,这项研究揭示了高危NDMM患者在维持治疗阶段传统方法的局限性,同时强调了整合新型药物的强化治疗方案的未来潜力。
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来源期刊
Clinical and Experimental Medicine
Clinical and Experimental Medicine 医学-医学:研究与实验
CiteScore
4.80
自引率
2.20%
发文量
159
审稿时长
2.5 months
期刊介绍: Clinical and Experimental Medicine (CEM) is a multidisciplinary journal that aims to be a forum of scientific excellence and information exchange in relation to the basic and clinical features of the following fields: hematology, onco-hematology, oncology, virology, immunology, and rheumatology. The journal publishes reviews and editorials, experimental and preclinical studies, translational research, prospectively designed clinical trials, and epidemiological studies. Papers containing new clinical or experimental data that are likely to contribute to changes in clinical practice or the way in which a disease is thought about will be given priority due to their immediate importance. Case reports will be accepted on an exceptional basis only, and their submission is discouraged. The major criteria for publication are clarity, scientific soundness, and advances in knowledge. In compliance with the overwhelmingly prevailing request by the international scientific community, and with respect for eco-compatibility issues, CEM is now published exclusively online.
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