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Association between response rates and survival outcomes in patients with newly diagnosed multiple myeloma. A systematic review and meta-regression analysis.

TitleAssociation between response rates and survival outcomes in patients with newly diagnosed multiple myeloma. A systematic review and meta-regression analysis.
Publication TypeJournal Article
Year of Publication2017
AuthorsMainou, M., Madenidou A-V., Liakos A., Paschos P., Karagiannis T., Bekiari E., Vlachaki E., Wang Z., Murad M. Hassan, Kumar S., & Tsapas A.
JournalEur J Haematol
Volume98
Issue6
Pagination563-568
Date Published2017 Jun
ISSN1600-0609
KeywordsAntineoplastic Combined Chemotherapy Protocols, Hematopoietic Stem Cell Transplantation, Humans, Multiple Myeloma, Randomized Controlled Trials as Topic, Regression Analysis, Remission Induction, Survival Analysis, Transplantation, Autologous, Treatment Outcome
Abstract

OBJECTIVES: We performed a systematic review and meta-regression analysis of randomized control trials to investigate the association between response to initial treatment and survival outcomes in patients with newly diagnosed multiple myeloma (MM).METHODS: Response outcomes included complete response (CR) and the combined outcome of CR or very good partial response (VGPR), while survival outcomes were overall survival (OS) and progression-free survival (PFS). We used random-effect meta-regression models and conducted sensitivity analyses based on definition of CR and study quality.RESULTS: Seventy-two trials were included in the systematic review, 63 of which contributed data in meta-regression analyses. There was no association between OS and CR in patients without autologous stem cell transplant (ASCT) (regression coefficient: .02, 95% confidence interval [CI] -0.06, 0.10), in patients undergoing ASCT (-.11, 95% CI -0.44, 0.22) and in trials comparing ASCT with non-ASCT patients (.04, 95% CI -0.29, 0.38). Similarly, OS did not correlate with the combined metric of CR or VGPR, and no association was evident between response outcomes and PFS. Sensitivity analyses yielded similar results.CONCLUSIONS: This meta-regression analysis suggests that there is no association between conventional response outcomes and survival in patients with newly diagnosed MM.

DOI10.1111/ejh.12868
Alternate JournalEur J Haematol
PubMed ID28178364

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