Pomalidomide combined with dexamethasone for the treatment of relapsed/refractory multiple myeloma: a systematic review and meta-analysis.

IF 2.3 4区 医学 Q2 HEMATOLOGY Expert Review of Hematology Pub Date : 2024-04-01 Epub Date: 2024-03-05 DOI:10.1080/17474086.2024.2326219
Ying Luo, Chen Li, Yuanchen Niu, Shuanzhi Wu, Jingyuan Tian, Zhiqin Hu, Jin He, Zhixin Zhang, Haiyan Liu, Yongmei Li, Tenghua Wang, Yi Fang
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Abstract

Background: To evaluate the efficacy and safety of pomalidomide in combination treatment of relapsed/refractory multiple myeloma (RRMM).

Methods: Published clinical trials were searched in the Cochrane Library, PubMed, EMBASE to February 2023. The literature was screened and evaluated according to the inclusion criteria, and the data were analyzed by a random effect model. Overall response rate (ORR), overall survival (OS), progression-free survival (PFS) and full grade or ≥ 3 adverse events (AEs) were the outcomes.

Results: This study included 31 clinical trials, which included 4776 patients. The pooled ORR of the doublet regimens was 33.3% (95%CI: 27-39%) and the triplet regimens was 66% (95%CI: 58-74%). Among the 25 included studies, the median PFS was 8.29 months (95%CI: 7.27-9.31), and nine studies reported median OS of 19.43 months (95%CI: 14.56-24.30). In terms of safety, the most common hematologic AEs of grade ≥ 3 were neutropenia (41%) and anemia (20%); Non-hematologic AEs were pneumonia (14%) and infection/febrile neutropenia (14%).

Conclusions: Pomalidomide combined treatment regimens have shown good clinical efficacy, especially in pomalidomide + dexamethasone combined with other drugs. In terms of safety, it's important to pay attention to the likelihood of hematological adverse events when used clinically.

Systematic review registration: PROSPERO: CRD42023420644.

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泊马度胺联合地塞米松治疗复发/难治性多发性骨髓瘤:系统综述和荟萃分析。
背景:评估泊马度胺联合治疗复发性/难治性多发性骨髓瘤(RRMM)的有效性和安全性:评估泊马度胺联合治疗复发性/难治性多发性骨髓瘤(RRMM)的有效性和安全性:方法:在Cochrane图书馆、PubMed和EMBASE中检索了截至2023年2月已发表的临床试验。根据纳入标准对文献进行筛选和评估,并采用随机效应模型对数据进行分析。研究结果包括总反应率(ORR)、总生存期(OS)、无进展生存期(PFS)和全级或≥3级不良事件(AEs):本研究包括31项临床试验,共纳入4776例患者。双联方案的总ORR为33.3%(95%CI:27-39%),三联方案为66%(95%CI:58-74%)。在纳入的 25 项研究中,中位 PFS 为 8.29 个月(95%CI:7.27-9.31),9 项研究的中位 OS 为 19.43 个月(95%CI:14.56-24.30)。在安全性方面,最常见的≥3级血液学AE为中性粒细胞减少(41%)和贫血(20%);非血液学AE为肺炎(14%)和感染/发热性中性粒细胞减少(14%):结论:泊马度胺联合治疗方案显示出良好的临床疗效,尤其是泊马度胺+地塞米松与其他药物联合治疗。在安全性方面,临床应用时必须注意发生血液学不良事件的可能性。
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来源期刊
CiteScore
4.70
自引率
3.60%
发文量
98
审稿时长
6-12 weeks
期刊介绍: Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.
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