Induction regimens for transplant-eligible patients with newly diagnosed multiple myeloma: a network meta-analysis of randomized controlled trials

Zeng, Zhao-Yi; Chen, Jiafeng; Li, Yixuan; Zhang, Ran; Xiao, Lingfei; Meng, Xiangyu

doi:10.2147/cmar.s138932

Cited by 9 publications

(29 citation statements)

References 38 publications

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“… 18 – 24 When pooling the data regarding postoperative morbidity and mortality, low to moderate levels of heterogeneity were observed between studies, indicating the need for a meta-analysis that integrated the appropriate statistics to draw global conclusions. 3 , 29 …”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery programs in lung cancer surgery: systematic review and meta-analysis of randomized controlled trials

Li¹,

Zhou²,

Che³

et al. 2017

CMAR

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BackgroundEnhanced recovery after surgery (ERAS) program is an effective evidence-based multidisciplinary protocol of perioperative care, but its roles in thoracic surgery remain unclear. This systematic review of randomized controlled trials (RCTs) aims to investigate the efficacy and safety of the ERAS programs for lung cancer surgery.Materials and methodsWe searched the PubMed and EMBASE databases to identify the RCTs that implemented an ERAS program encompassing more than four care elements within at least two phases of perioperative care in lung cancer surgery. The heterogeneity levels between studies were estimated by the Cochrane Collaborations. A qualitative review was performed if considerable heterogeneity was revealed. Relative risk (RR) and weighted mean difference served as the summarized statistics for the meta-analyses. Additional analyses were also performed to perceive potential bias risks.ResultsA total of seven RCTs enrolling 486 patients were included. The meta-analysis indicated that the ERAS group patients had significantly lower morbidity rates (RR=0.64; p<0.001), especially the rates of pulmonary (RR=0.43; p<0.001) and surgical complications (RR=0.46; p=0.010), than those of control group patients. No significant reduction was found in the in-hospital mortality (RR=0.70; p=0.58) or cardiovascular complications (RR=1.46; p=0.25). In the qualitative review, most of the evidence reported significantly shortened length of hospital and intensive care unit stay and decreased hospitalization costs in the ERAS-treated patients. No significant publication bias was detected in the meta-analyses.ConclusionOur review demonstrates that the implementation of an ERAS program for lung cancer surgery can effectively accelerate postoperative recovery and save hospitalization costs without compromising patients’ safety. A worldwide consensus guideline is urgently required to standardize the ERAS protocols for elective lung resections in the future.

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Section: Discussionmentioning

confidence: 99%

Enhanced recovery programs in lung cancer surgery: systematic review and meta-analysis of randomized controlled trials

Li¹,

Zhou²,

Che³

et al. 2017

CMAR

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“…These drugs showed evident beneficial effects in trials involving patients with refractory and/or relapsed MM, among which the Tha, Len, and Bor are the most widely used in clinical practice for MM maintenance, as single agent or in combined regimens ( Chen J.F. et al, 2017 ; Sengsayadeth et al, 2017 ; Terpos and International Myeloma Society, 2017 ; Zeng et al, 2017 ). Tha and Len are IMiDs.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment strategies based on autologous stem cell transplantation (ASCT) and newly developed agents (e.g., Bor, Tha, and Len) have significantly improved the outcome of patients with MM ( Chen J.F. et al, 2017 ; Zeng et al, 2017 ). However, due to inevitable disease progression and relapse, it remains incurable ( Chen W.C. et al, 2017 ; Moreau and de Wit, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Long-Term Efficacy of Maintenance Therapy for Multiple Myeloma: A Quantitative Synthesis of 22 Randomized Controlled Trials

Guang-yu

Liu

et al. 2018

Front. Pharmacol.

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We aimed to quantitatively synthesize data from randomized controlled trials (RCTs) concerning maintenance for multiple myeloma (MM). We searched electronic literature databases and conference proceedings to identify relevant RCTs. We selected eligible RCTs using predefined selection criteria. We conducted meta-analysis comparing maintenance containing new agents and conventional maintenance, and subgroup analysis by transplantation status and mainstay agent as well. We performed trial sequential analysis (TSA) to determine adequacy of sample size for overall and subgroup meta-analyses. We performed network meta-analysis (NMA) to compare and rank included regimens. A total of 22 RCTs involving 9,968 MM patients and 15 regimens were included, the overall quality of which was adequate. Significant heterogeneity was detected for progression-free survival (PFS) but not overall survival (OS). Meta-analyses showed that maintenance containing new agents significantly improved PFS but not OS [PFS: Hazard Ratio (HR) = 0.59, 95% Confidence Interval (CI) = 0.54 to 0.64; OS: HR = 0.93, 95% CI = 0.87 to 1.00], compared with controls. Subgroup analyses revealed lenalidomide (Len)-based therapies better than thalidomide-based ones (HR = 0.50 and 0.66, respectively; P = 0.001). NMA revealed that most of the maintenance regimens containing new agents were significantly better than simple observation in terms of PFS but not OS. Len single agent was the most effective, considering PFS and OS both. We concluded that conventional maintenance has very limited effect. Maintenance containing new agents is highly effective in improving PFS, but has very limited effect on OS. Maintenance with Len may have the largest survival benefits. Emerging strategies may further change the landscape of maintenance of MM.

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“…immunomodulatory drugs (such as lenalidomide and pomamide), proteasome inhibitors (such as bortezomib and carfilzomib) and monoclonal antibodies have significantly increased the survival rate of patients with MM over the past decade (23)(24)(25); however, the treatment of relapsed and partially refractory patients remains challenging. The pathogenesis and progression of MM involve complex and heterogeneous genomic alterations (26)(27)(28)(29)(30), including modifications that are influenced by lncRNAs.…”

Section: Introductionmentioning

confidence: 99%

Construction of a prognosis‑associated long noncoding RNA‑mRNA network for multiple myeloma based on microarray and bioinformatics analysis

Zhu

Wang

Ye³

et al. 2020

Mol Med Report

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at present, t he associat ion bet we en prognosis-associated long noncoding rnas (lncrnas) and mrnas is yet to be reported in multiple myeloma (MM). The aim of the present study was to construct prognostic models with lncrnas and mrnas, and to map the interactions between these lncrnas and mrnas in MM. lncrna and mrna data from 559 patients with MM were acquired from the Genome expression omnibus (dataset GSe24080), and their prognostic values were calculated using the survival package in r. Multivariate Cox analysis was used on the top 20 most significant prognosis-associated mrnas and lncrnas to develop prognostic signatures. The performances of these prognostic signatures were tested using the survivalroc package in r, which allows for time-dependent receiver operator characteristic (roc) curve estimation. Weighted correlation network analysis (WGcna) was conducted to investigate the associations between lncrnas and mrnas, and a lncrna-mrna network was constructed using cytoscape software. univariate cox regression analysis identified 39 lncRNAs and 1,445 mRNAs that were significantly associated with event-free survival of MM patients. The top 20 most significant survival-associated lncrnas and mrnas were selected as candidates for analyzing independent MM prognostic factors. Both signatures could be used to separate patients into two groups with distinct outcomes. The areas under the ROC curves were 0.739 for the lncRNA signature and 0.732 for the mRNA signature. In the lncRNA-mRNA network, a total of 143 mRNAs were positively or negatively associated with 23 prognosis-associated lncRNAs. NCRNA00201, LOC115110 and RP5-968J1.1 were the most dominant drivers. The present study constructed a model that predicted prognosis in MM and formed a network with the corresponding prognosis-associated mrnas, providing a novel perspective for the clinical diagnosis and treatment of MM, and suggesting novel directions for interpreting the mechanisms underlying the development of MM.

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Induction regimens for transplant-eligible patients with newly diagnosed multiple myeloma: a network meta-analysis of randomized controlled trials

Cited by 9 publications

References 38 publications

Enhanced recovery programs in lung cancer surgery: systematic review and meta-analysis of randomized controlled trials

Enhanced recovery programs in lung cancer surgery: systematic review and meta-analysis of randomized controlled trials

Long-Term Efficacy of Maintenance Therapy for Multiple Myeloma: A Quantitative Synthesis of 22 Randomized Controlled Trials

Construction of a prognosis‑associated long noncoding RNA‑mRNA network for multiple myeloma based on microarray and bioinformatics analysis

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