Induction Regimens for Untreated Multiple Myeloma Compared for ORR, OS, PFS

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The VTD regimen had significantly superior postinduction ORR, compared with the other regimens included in the study.
The VTD regimen had significantly superior postinduction ORR, compared with the other regimens included in the study.

The bortezomib plus thalidomide plus dexamethasone (VTD), VTD plus cyclophosphamide (VTDC), and thalidomide plus doxorubicin plus dexamethasone (TAD) regimens demonstrate early response and survival benefit in transplant-eligible patients with newly diagnosed multiple myeloma (MM), according to a study published in Cancer Management and Research.

Induction regimens including chemotherapeutic agents such as thalidomide, bortezomib, and lenalidomide have greatly improved outcomes in patients with MM, but there is a lack of robust clinical data in head to head comparison trials measuring outcomes in early treatment.

Study authors pooled data from 14 randomized control trials that administered 14 induction regimens to 4763 enrolled patients for this network meta-analysis. The key outcome measures investigated were objective response rate (ORR), overall survival (OS), and progression-free survival (PFS). 

The VTD regimen had significantly superior postinduction ORR, and was considered to provide the most clinical benefit compared with the other regimens included in the study.

The VTDC regimen showed potential superiority over VTD (hazard ratio [HR], 0.87; 95% CI, 0.44-1.72; P =.69) and the other regimens in regards to OS, but this improvement was statistically insignificant.

The TAD regimen had the longest PFS compared with VTD (HR, 0.66; 95% CI, 0.39-1.1), VTDC (HR, 0.91; 95% CI, 0.44-1.9), and other study regimens in patients with newly diagnosed MM.

The authors conclude however, that “the results of this [network meta-analysis] should be interpreted with caution, and more high-quality studies with adequate sample size are needed to confirm our findings.”

Reference

1. Zeng ZH, Chen JF, Li XY, et al. Induction regimens for transplant-eligible patients with newly diagnosed multiple myeloma: a network meta-analysis of randomized controlled trials [published online July 10, 2017]. Cancer Manag Res. doi: 10.2147/CMAR.S138932

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