Premium
Postrelapse survival rate correlates with first‐line treatment strategy with thalidomide in patients with newly diagnosed multiple myeloma: a meta‐analysis
Author(s) -
Wang Lida,
Cui Jingying,
liu Liping,
Sheng Zhixin
Publication year - 2012
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.1025
Subject(s) - thalidomide , medicine , hazard ratio , multiple myeloma , oncology , autologous stem cell transplantation , meta analysis , transplantation , randomized controlled trial , progression free survival , confidence interval , clinical trial , overall survival , surgery
To define whether or not thalidomide exposure upfront to newly diagnosed patients with multiple myeloma would adversely impact postrelapse survival (PRS), we performed a meta‐analysis of randomized controlled trials. Medline, Embase, the Cochrane controlled trials register and the Science Citation Index were searched. Thirteen trials were identified, covering a total of 6097 subjects, and PRS data were available from eight trials. The summary hazard ratio (thalidomide vs control) of all those trials for PRS was 1.23 [95% CI, 1.05–1.45]. The HRs of thalidomide maintenance subgroups were 0.90 [0.57–1.41] for PRS, 0.61 [0.44–0.83] for progression‐free survival ( PFS) and 0.54 [0.36–0.80] for overall survival, respectively. The corresponding ratios of thalidomide induction and maintenance subgroups were 1.41 [1.13–1.76] for PRS, 0.68 [0.59–0.79] for PFS and 0.87 [0.73–1.04] for overall survival, respectively. In conclusion, thalidomide exposed upfront correlated with shorter PRS that partially compensated for prolonged initially PFS and resulted in no survival benefit when it is given as both induction pre‐autologous and maintenance post‐autologous stem cell transplantation; shorter PRS was not observed, and survival was improved when it is given only during maintenance phase following autologous stem cell transplantation in the patients with myeloma and who are eligible for transplant. Copyright © 2011 John Wiley & Sons, Ltd.