Maintenance Therapy with Immunomodulatory Drugs after Autologous Stem Cell Transplantation in Patients with Multiple Myeloma: A Meta-Analysis of Randomized Controlled TrialsReport as inadecuate




Maintenance Therapy with Immunomodulatory Drugs after Autologous Stem Cell Transplantation in Patients with Multiple Myeloma: A Meta-Analysis of Randomized Controlled Trials - Download this document for free, or read online. Document in PDF available to download.

Background

Although high-dose therapy HDT with autologous stem cell transplantation ASCT has been confirmed to result in longer remission time than conventional chemotherapy, multiple myeloma MM remains incurable. Post-ASCT maintenance is considered as a strategy for obtaining durable remissions and preventing tumor progression. Randomized controlled trials RCTs studying maintenance therapy with immunomodulatory drugs IMiDs after ASCT have shown some valuable survival improvements. This meta-analysis of RCTs therefore assesses the effect of post-ASCT IMiDs maintenance on MM patients.

Methods

We performed a meta-analysis to evaluate the impact of IMiDs thalidomide or lenalidomide as post-ASCT maintenance therapy on the survival of newly diagnosed MM patients. The outcomes for this meta-analysis were progression-free survival PFS and overall survival OS.

Results

Eight RCTs enrolling 3514 patients were included for analysis. An obvious improvement in Os hazard ratio HR 0.75 and a significant PFS advantage HR 0.58 with post-ASCT IMiDs maintenance was revealed. Thalidomide maintenance after ASCT can result in significant benefit in Os HR 0.72, particularly combined with corticosteroids HR 0.66.

Conclusions

MM patients after ASCT have a significant overall survival benefit with IMiDs maintenance. IMiDs maintenance was justified for MM patients who received HDT with ASCT.



Author: Xueshi Ye, Jinwen Huang, Qin Pan, Wanli Li

Source: http://plos.srce.hr/



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