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Efficacy and Safety of Lenalidomide in the Treatment of Multiple Myeloma: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Qiao, Shu-Kai1; Guo, Xiao-Nan1; Ren, Jin-Hai1; Ren, Han-Yun2
关键词Lenalidomide Meta-analysis Multiple Myeloma
刊名CHINESE MEDICAL JOURNAL
2015-05-05
DOI10.4103/0366-6999.156134
128期:9页:1215-1222
收录类别SCI
文章类型Review
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]STEM-CELL TRANSPLANTATION ; PLUS DEXAMETHASONE ; THERAPY ; THALIDOMIDE ; SURVIVAL ; DRUG ; PHASE-2 ; CC-5013
英文摘要

Background: Lenalidomide has emerged as an important treatment for patients with multiple myeloma (MM). However, its role in the management of MM is still controversial and requires further clarification. The aim of this study was to evaluate efficacy and safety of lenalidomide for MM using a meta-analysis.

Methods: We searched the electronic databases including: PubMed, EMBASE and the Cochrane Center Register of Controlled Trials. Seven randomized clinical trials were identified, which included a total of 2357 patients with MM who received lenalidomide-containing, noncontaining lenalidomide regimens or placebo as induction therapy or maintenance therapy. The outcomes included overall response (OR) rate, complete response (CR) rate, 3-year progression-free survival (PFS) rate, 3-year overall survival (OS) rate, and different types of treatment-related adverse events. We calculated the risk ratios (RRs) as well as their 95% confidence intervals of these outcomes and pooled the results using RevMan 5.2 software.

Results: For patients with previously untreated MM, OR rate and CR rate was significantly higher in lenalidomide-containing group than the control group. For relapsed or refractory MM patients, lenalidomide-containing regimens significantly improved the OR rate, CR rate, 3-year PFS rate and 3-year OS rate. With regard to MM patients after autologous stem cell transplantation, lenalidomide maintenance therapy significantly improved 3-year PFS rate but did not result in improved 3-year OS rate. In terms of toxicities, lenalidomide therapy has a higher rate of Grade 3-4 grade cytopenias, infection, deep-vein thrombosis, and diarrhea. Furthermore, the incidence of second primary malignancies was significantly higher in the lenalidomide group.

Conclusions: The lenalidomide-containing regimens as induction therapy clearly increased response rates and improved intervals of survival with acceptable toxicity rates for patients with MM. However, when physicians choose to use the lenalidomide as maintenance therapy, whether the benefits outweigh the risks should be taken into account.

语种英语
WOS记录号WOS:000354186800014
引用统计
被引频次:9[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/54412
专题北京大学第一临床医学院_血液内科
作者单位1.Hebei Med Univ, Hosp 2, Dept Hematol, Shijiazhuang 050000, Hebei, Peoples R China
2.Peking Univ, Hosp 1, Dept Hematol, Beijing 100034, Peoples R China
推荐引用方式
GB/T 7714
Qiao, Shu-Kai,Guo, Xiao-Nan,Ren, Jin-Hai,et al. Efficacy and Safety of Lenalidomide in the Treatment of Multiple Myeloma: A Systematic Review and Meta-analysis of Randomized Controlled Trials[J]. CHINESE MEDICAL JOURNAL,2015,128(9):1215-1222.
APA Qiao, Shu-Kai,Guo, Xiao-Nan,Ren, Jin-Hai,&Ren, Han-Yun.(2015).Efficacy and Safety of Lenalidomide in the Treatment of Multiple Myeloma: A Systematic Review and Meta-analysis of Randomized Controlled Trials.CHINESE MEDICAL JOURNAL,128(9),1215-1222.
MLA Qiao, Shu-Kai,et al."Efficacy and Safety of Lenalidomide in the Treatment of Multiple Myeloma: A Systematic Review and Meta-analysis of Randomized Controlled Trials".CHINESE MEDICAL JOURNAL 128.9(2015):1215-1222.
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