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2017 ; 8
(20
): 34001-34017
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Systematic review and meta-analysis of the efficacy and safety of novel
monoclonal antibodies for treatment of relapsed/refractory multiple myeloma
#MMPMID28454113
Zhang T
; Wang S
; Lin T
; Xie J
; Zhao L
; Liang Z
; Li Y
; Jiang J
Oncotarget
2017[May]; 8
(20
): 34001-34017
PMID28454113
show ga
Although two newly launched monoclonal antibodies (mAbs), elotuzumab and
daratumumab, performed well in patients with relapsed or relapsed/refractory
multiple myeloma (RRMM), their efficacy and safety remain uncertain. We therefore
performed a systematic review and meta-analysis of the most recent clinical
trials that evaluated elotuzumab and/or daratumumab for the treatment of patients
with RRMM. Our meta-analysis included 13 clinical trials with 2,402 patients
participating. The overall response rate (ORR) was 57% (95% confidence interval
[CI]: 38-76%), and the at least very good partial response rate (VGPR) was 32%
(95% CI: 19-46%). mAb-based regimens prolonged progression-free survival (PFS,
hazard ratio: 0.52, 95% CI: 0.36-0.75) compared to non-mAb-based regimens.
Additionally, the efficacy of triplet regimens was superior to that of single or
doublet regimens. The same trend was observed in a subgroup analysis of
daratumumab and elotuzumab. The most common grade 3/4 adverse events included
neutropenia, lymphopenia, thrombocytopenia, anemia, leukopenia, pneumonia, and
fatigue. Elotuzumab and daratumumab improved the ORR, at least VGPR, and PFS
compared to non-mAb-based regimens. In a pooled analysis, both mAbs had promising
efficacy and safety profiles, particularly in triplet regimens. The same trend
was observed in daratumumab- and elotuzumab-based regimens. Daratumumab triplet
therapy (daratumumab, lenalidomide, and dexamethasone) was superior to other
triplet regimens for the treatment of RRMM, and daratumumab monotherapy was more
effective than either single agent in heavily pretreated MM patients, suggesting
CD38 is an effective target for treatment of RRMM. Additional clinical studies of
elotuzumab and daratumumab will be required to validate these results.
|Antibodies, Monoclonal/administration & dosage/adverse effects/*therapeutic use
[MESH]
|Antineoplastic Agents, Immunological/administration & dosage/adverse
effects/*therapeutic use
[MESH]
|Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use
[MESH]