(Bortezomib plus lenalidomide/thalidomide)- vs (bortezomib or lenalidomide/thalidomide)-containing regimens as induction therapy in newly diagnosed multiple myeloma: a meta-analysis of randomized controlled trials
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The aim of the study was to perform a meta-analysis of the efficacy and safety of (bortezomib plus lenalidomide/thalidomide)- vs (bortezomib or lenalidomide/thalidomide)-containing regimens as induction therapy in newly diagnosed multiple myeloma. We searched electronic and printed sources for relevant articles published. Inclusion criteria was as follows: randomized controlled trials (RCT) of (bortezomib plus lenalidomide/thalidomide) vs (bortezomib or lenalidomide/thalidomide)-containing regimens as induction therapy in newly diagnosed multiple myeloma. Two reviewers independently assessed potentially eligible studies and extracted relevant data. We retrieved five RCT studies including a total of 1,200 patients. Using the random-effects model to pool the five RCT with a statistically significant heterogeneity (P = 0.03; X 2 = 10.69; df = 4; I 2 = 63 %), the weighted risk ratios of a complete response (CR) for (bortezomib plus lenalidomide/thalidomide)-containing regimens was 1.81 (P = 0.005; 95 % CI: 1.20–2.73). When we excluded the study by Cavo et al. (Lancet 376:2075–2085, 2010), the pooled risk ratio for CR was 1.59 (P < 0.0001, 95 %CI: 1.29–1.96) with no statistically significant heterogeneity (P = 0.54; X 2 = 2.14; df = 3; I 2 = 0 %) among four RCT under the fixed effects mode. The pooled odds ratio for the main grade III/IV adverse events (the peripheral neuropathy, thrombotic events, and infections) were 1.76 (P = 0.32; 95 % CI: 0.58–5.31), 0.92 (P = 0.76, 95 %CI: 0.52–1.61), and 1.05 (P = 0.82, 95 % CI: 0.70–1.57), respectively. Our analysis showed (bortezomib plus lenalidomide/thalidomide)-containing regimens as induction treatment in newly diagnosed multiple myeloma improved CR but did not increase the risk of major adverse events (the peripheral neuropathy, thrombotic events, and infections).
KeywordsMultiple myeloma Bortezomib Lenalidomide Thalidomide Meta-analysis
Conflict of interest
The authors state that they have no conflict of interest.
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