Efficacy and Safety of triplet versus doublet regimens in patients with multiple myeloma: A systematic review and meta-analysis

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer Pub Date : 2025-04-03 DOI:10.1016/j.currproblcancer.2025.101202

Zilu Meng , Hanxue Zheng , Yanhong Li , Jun Bai , Liansheng Zhang , Lijuan Li

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引用次数: 0

Abstract

Background

The efficacy and safety of various therapies for multiple myeloma (MM) remain a subject of ongoing debate, with inconsistent findings. This meta-analysis aimed to compare the efficacy and safety of triplet versus doublet regimens in the management of MM. This study followed the guidelines delineated in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 statement, with our protocol duly registered in PROSPERO (CRD42024527903).

Methods

An exhaustive literature search was performed across four databases, PubMed, EMBASE, Web of Science, and Cochrane Library, from their commencement to March 5, 2024. Data on overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), adverse events (AEs), and grade ≥ 3 AEs were synthesized using either random-effects or fixed-effects models.

Results

This analysis considered 29 studies, which cover approximately 11,230 MM patients in total. Triplet regimens were found to yield better PFS and OS for MM patients as compared to the doublet regimens. Although the incidence of serious AEs was higher under the triplet regimens, with pooled RRs of grade ≥ 3 AEs reaching 1.13. Besides, subgroup analysis demonstrated that patients with relapsed/refractory multiple myeloma (RRMM) tended to have better PFS and OS under triple therapy, in contrast to newly diagnosed multiple myeloma (NDMM) and older adults, who experienced little to no significant impact.

Conclusions

Triplet regimens demonstrate superior PFS and OS compared to doublet regimens in MM patients, but also have a higher likelihood of causing AEs of grade 3 or 4.

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多发性骨髓瘤患者三联与双联治疗方案的疗效和安全性：一项系统回顾和荟萃分析

各种治疗多发性骨髓瘤（MM）的疗效和安全性仍然是一个持续争论的主题，研究结果不一致。本荟萃分析旨在比较三联和双联治疗方案在MM治疗中的疗效和安全性。本研究遵循系统评价和荟萃分析首选报告项目（PRISMA） 2020声明中所描述的指南，我们的方案已在PROSPERO （CRD42024527903）正式注册。方法对PubMed、EMBASE、Web of Science、Cochrane Library 4个数据库进行全面的文献检索，检索时间从数据库启动到2024年3月5日。总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）、疾病控制率（DCR）、不良事件（ae）和≥3级ae的数据采用随机效应或固定效应模型合成。本分析纳入了29项研究，共涉及约11,230例MM患者。与双重方案相比，三重方案对MM患者产生更好的PFS和OS。虽然在三组方案下严重ae的发生率更高，≥3级ae的合并rr达到1.13。此外，亚组分析显示，与新诊断的多发性骨髓瘤（NDMM）和老年人相比，复发/难治性多发性骨髓瘤（RRMM）患者在三联治疗下往往有更好的PFS和OS，而新诊断的多发性骨髓瘤（NDMM）患者几乎没有显著影响。结论在MM患者中，三联体方案的PFS和OS优于双联体方案，但也有更高的可能性导致3级或4级ae。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cancer 医学-肿瘤学

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

15 days

期刊介绍： Current Problems in Cancer seeks to promote and disseminate innovative, transformative, and impactful data on patient-oriented cancer research and clinical care. Specifically, the journal''s scope is focused on reporting the results of well-designed cancer studies that influence/alter practice or identify new directions in clinical cancer research. These studies can include novel therapeutic approaches, new strategies for early diagnosis, cancer clinical trials, and supportive care, among others. Papers that focus solely on laboratory-based or basic science research are discouraged. The journal''s format also allows, on occasion, for a multi-faceted overview of a single topic via a curated selection of review articles, while also offering articles that present dynamic material that influences the oncology field.