基于venetoclax的方案治疗复发或难治性多发性骨髓瘤的疗效和安全性:前瞻性临床试验的系统回顾和荟萃分析

IF 4.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Annals of medicine Pub Date : 2023-12-01 DOI:10.1080/07853890.2023.2186480

Wei He, Fang He, Huixian Hu

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引用次数: 0

摘要

背景：多发性骨髓瘤是一种无法治愈的恶性肿瘤。Venetoclax（VEN）对既往标准治疗的复发或难治性MM患者显示出有意义的疗效。目的：本研究旨在评估基于VEN的治疗RR MM患者的疗效和安全性。材料和方法：检索PubMed、Embase、Web of Science和Cochrane图书馆的综合研究。疗效通过总有效率（ORR）、完全有效率（sCR）、全部有效率（CR）、非常好部分有效率（VGPR）和部分有效率来评估。合并ORR≥CR（sCR + CR）、VGPR和PR分别为68%（51%-85%）、24%（13%-35%）、25%（17%-34%）和17%（11%-24%）。多种药物治疗优于VEN ± 地塞米松（Dex）治疗ORR（82%对42%，p = .003）和 ≥ CR（36%对7%，p 结论：对于t（11；14）或高BCL-2水平的RR-MM患者，含VEN的方案可能是有效和安全的治疗方法。

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Efficacy and safety of Venetoclax-based regimens in relapsed or refractory multiple myeloma: a systematic review and meta-analysis of prospective clinical trials.

Background: Multiple myeloma (MM) is an incurable malignancy. Venetoclax (VEN) shows a meaningful effect in MM patients who are relapsed or refractory (RR) to previous standard therapies.

Objective: This study aimed to assess the efficacy and safety of VEN-based treatments in RR MM patients.

Materials and methods: Comprehensive studies were searched in PubMed, Embase, Web of Science and Cochrane library. Efficacy was assessed by overall response rate (ORR), strict complete response rate (sCR), complete response rate (CR), very good partial response rate (VGPR) and partial response rate (PR).

Results: Seven studies containing 482 subjests were included. The pooled ORR, ≥ CR (sCR + CR), VGPR and PR were 68% (51%-85%), 24% (13%-35%), 25% (17%-34%) and 17% (11%-24%) respectively. Multi-drug treatments were superior to VEN ± dexamethasone (Dex) treatments in ORR (82% vs 42%, p = .003) and ≥ CR (36% vs 7%, p < 0.00001). Subgroup analysis indicated patients achieve higher ORR who harboring t(11;14) translocation or containing high BCL-2 expression.

Conclusions: VEN-containing regimens could be suggested as effective and safe treatments to RR MM patients with t(11;14) or high BCL-2 levels.

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来源期刊

Annals of medicine 医学-医学：内科

CiteScore

4.90

自引率

0.00%

发文量

292

审稿时长

3 months

期刊介绍： Annals of Medicine is one of the world’s leading general medical review journals, boasting an impact factor of 5.435. It presents high-quality topical review articles, commissioned by the Editors and Editorial Committee, as well as original articles. The journal provides the current opinion on recent developments across the major medical specialties, with a particular focus on internal medicine. The peer-reviewed content of the journal keeps readers updated on the latest advances in the understanding of the pathogenesis of diseases, and in how molecular medicine and genetics can be applied in daily clinical practice.