Comparative Meta-Analysis of Triplet vs. Quadruplet Induction Regimens in Newly Diagnosed, Treatment Naïve, Multiple Myeloma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Study Selection
3.2. Meta-Analysis for Efficacy of 4-Drug vs. 3-Drug Induction Regimen in NDMM
3.3. Meta-Analysis for Toxicity of a 4-Drug vs. 3-Drug Induction Regimen in NDMM
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | Phase | Population | 3-Drug Arm (N) | 4-Drug Arm (N) | MRD Reported? | Reference |
---|---|---|---|---|---|---|
Alcyone | 3 | NDMM | VMP (356) | Dara-VMP (350) | Yes | [21] |
CASSIOPEIA | 3 | NDMM | VTd (542) | Dara-VTd (543) | Yes | [14] |
S1211 | 2 | HR-NDMM | RVd (52) | Elo-RVd (48) | No | [22] |
PERSEUS | 3 | NDMM | RVd (354) | Dara-RVd (355) | Yes | [23] |
GRIFFIN | 2 | NDMM | RVd (103) | Dara-RVd (104) | Yes | [15] |
MYELOMA XI+ | 3 | NDMM | RVd (265)TVd (265) | KRD-Cy (526) | Yes | [24] |
MYELOMA IX | 3 | NDMM | Cy-Td (555) | Cy-VAD (556) | No | [25] |
EVOLUTION | 2 | NDMM | RVd (42)Cy-Vd (50) | Cy-RVd (48) | Yes | [26] |
GREEK MM STUDY GROUP | 3 | NDMM | VAd (115) | T-VAd (117) | No | [27] |
GIMEMA-MM-03-05 | 3 | NDMM | VMP (253) | T-VMP (250) | No | [19] |
GMMG-HD7 | 3 | NDMM | RVd (329) | Isa-RVd (331) | Yes | [28] |
Alcyone | CASSIOPEIA | S1211 | PERSEUS | GRIFFIN | MYELOMA XI+ | MYELOMA IX | EVOLUTION | GREEK MM STUDY GROUP | GIMEMA-MM-03-05 | GMMG-HD7 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
3-Drug (N = 354) | 4-Drug (N = 346) | 3-Drug (N = 542) | 4-Drug (N = 543) | 3-Drug (N = 52) | 4-Drug (N = 48) | 3-Drug (N = 354) | 4-Drug (N = 355) | 3-Drug (N = 103) | 4-Drug (N = 104) | 3-Drug (N = 530) | 4-Drug (N = 526) | 3-Drug (N = 555) | 4-Drug (N = 556) | 3-Drug (N = 92) | 4-Drug (N = 48) | 3-Drug (N = 115) | 4-Drug (N = 117) | 3-Drug (N = 253) | 4-Drug (N = 250) | 3-Drug (N = 329) | 4-Drug (N = 331) | |
Neutropenia | ||||||||||||||||||||||
All grades | 52.5 | 49.7 | 16.4 | 28.9 | 32.7 | 37.5 | 57.6 | 68.5 | 35.0 | 54.8 | 45.1 | 48.7 | NR | NR | NR | NR | 24.3 | 17.9 | NR | NR | 7.0 | 23.3 |
Grades 3/4 | 38.7 | 39.9 | 14.6 | 27.3 | 9.6 | 16.7 | 50.0 | 61.4 | 21.4 | 39.4 | 17.2 | 16.0 | NR | NR | 19.6 | 43.8 | 10.4 | 7.7 | 28.1 | 38.4 | 7.0 | 23.3 |
Anemia | ||||||||||||||||||||||
All grades | 37.6 | 28.0 | NR | NR | 1.9 | 0.0 | 20.3 | 22.0 | 32.0 | 33.7 | 72.8 | 77.2 | NR | NR | NR | NR | NR | NR | NR | NR | 6.1 | 3.9 |
Grades 3/4 | 19.8 | 15.9 | NR | NR | 0.0 | 0.0 | 6.2 | 5.9 | 5.8 | 8.7 | 5.1 | 9.9 | NR | NR | 5.4 | 8.3 | NR | NR | 9.9 | 10.0 | 6.1 | 3.9 |
Thrombocytopenia | ||||||||||||||||||||||
All grades | 53.7 | 48.8 | 13.5 | 20.1 | 61.5 | 54.2 | 33.6 | 47.9 | 35.0 | 41.3 | 23.4 | 48.7 | NR | NR | NR | NR | 13.0 | 9.4 | NR | NR | 4.6 | 6.6 |
Grades 3/4 | 37.6 | 34.4 | 7.4 | 10.9 | 19.2 | 20.8 | 16.9 | 28.7 | 8.7 | 15.4 | 1.7 | 5.9 | NR | NR | 9.8 | 14.6 | 7.8 | 4.3 | 19.8 | 22.0 | 4.6 | 6.3 |
Neuropathy (%) | ||||||||||||||||||||||
All grades | 34.2 | 28.3 | 62.7 | 57.8 | 61.5 | 79.2 | 50.6 | 53.0 | 71.8 | 56.7 | 35.1 | 20.0 | NR | NR | 70.7 | 68.8 | 46.1 | 12.8 | NR | NR | 31.9 | 27.2 |
Grades 3/4 | 4.0 | 1.4 | 8.5 | 8.7 | 11.5 | 8.3 | 4.0 | 4.2 | 7.8 | 6.7 | 0.8 | 0.2 | NR | NR | 14.1 | 12.5 | 6.1 | 0.9 | 5.1 | 10.8 | 7.6 | 6.6 |
Infections | ||||||||||||||||||||||
All grades | 48.0 | 66.8 | 56.5 | 64.6 | 28.8 | 25.0 | 75.1 | 85.9 | 61.2 | 86.5 | NR | NR | NR | NR | NR | NR | 11.3 | 15.4 | NR | NR | 22.8 | 25.4 |
Grades 3/4 | 14.7 | 1.4 | 21.8 | 19.3 | 15.4 | 8.3 | 26.8 | 34.9 | 21.4 | 22.1 | NR | NR | NR | NR | NR | NR | 6.1 | 8.5 | 9.1 | 12.8 | 9.7 | 12.1 |
URI | ||||||||||||||||||||||
All grades | 13.8 | 26.3 | NR | NR | 7.7 | 6.3 | 24.6 | 31.3 | 43.7 | 59.6 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
Grades 3/4 | 1.4 | 2.0 | NR | NR | 0.0 | 0.0 | 1.7 | 0.6 | 1.9 | 1.0 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
Pneumonia | ||||||||||||||||||||||
All grades | 4.8 | 15.3 | 1.7 | 3.5 | 0.0 | 0.0 | 10.7 | 18.0 | 10.7 | 8.7 | 16.0 | 16.2 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
Grades 3/4 | 4.0 | 11.3 | NR | NR | 0.0 | 0.0 | 5.9 | 10.4 | 10.7 | 7.7 | 7.9 | 10.3 | NR | NR | 3.3 | 4.2 | NR | NR | 2.4 | 5.6 | NR | NR |
Diarrhea | ||||||||||||||||||||||
All grades | 24.6 | 23.7 | NR | NR | 73.1 | 85.4 | 53.1 | 60.3 | 49.5 | 56.7 | 23.2 | 28.7 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
Grades 3/4 | 3.1 | 2.6 | NR | NR | 3.8 | 14.6 | 7.6 | 0.8 | 3.9 | 49.0 | 1.7 | 2.9 | NR | NR | 3.3 | 6.3 | NR | NR | 2.8 | 1.6 | NR | NR |
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Paul, B.; Anwer, F.; Raza, S.; Mammadzadeh, A.; Khasawneh, B.; Shatnawi, S.; McGuirk, J.; Ahmed, N.; Mahmoudjafari, Z.; Mushtaq, M.; et al. Comparative Meta-Analysis of Triplet vs. Quadruplet Induction Regimens in Newly Diagnosed, Treatment Naïve, Multiple Myeloma. Cancers 2024, 16, 2938. https://doi.org/10.3390/cancers16172938
Paul B, Anwer F, Raza S, Mammadzadeh A, Khasawneh B, Shatnawi S, McGuirk J, Ahmed N, Mahmoudjafari Z, Mushtaq M, et al. Comparative Meta-Analysis of Triplet vs. Quadruplet Induction Regimens in Newly Diagnosed, Treatment Naïve, Multiple Myeloma. Cancers. 2024; 16(17):2938. https://doi.org/10.3390/cancers16172938
Chicago/Turabian StylePaul, Barry, Faiz Anwer, Shahzad Raza, Aytaj Mammadzadeh, Bayan Khasawneh, Sara Shatnawi, Joseph McGuirk, Nausheen Ahmed, Zahra Mahmoudjafari, Muhammad Mushtaq, and et al. 2024. "Comparative Meta-Analysis of Triplet vs. Quadruplet Induction Regimens in Newly Diagnosed, Treatment Naïve, Multiple Myeloma" Cancers 16, no. 17: 2938. https://doi.org/10.3390/cancers16172938