PMID- 31444819
OWN - NLM
STAT- MEDLINE
DCOM- 20200326
LR  - 20200326
IS  - 1600-0609 (Electronic)
IS  - 0902-4441 (Linking)
VI  - 103
IP  - 6
DP  - 2019 Dec
TI  - Daratumumab added to standard of care in patients with newly diagnosed multiple 
      myeloma: A network meta-analysis.
PG  - 542-551
LID - 10.1111/ejh.13317 [doi]
AB  - PURPOSE: To investigate the activity and safety of daratumumab added to standard 
      of care and evaluate the relative efficacy of DRd vs DVMP and other regimens on 
      survival endpoints for untreated myeloma, we undertook this meta-analysis. 
      METHODS: We searched published reports that described the activity and safety of 
      daratumumab added to standard of care for untreated myeloma. RESULTS: Six 
      daratumumab trials were identified, covering 5106 subjects. Daratumumab 
      containing combinations for untreated myeloma attained an impressive complete 
      response or better (>/=CR) rate of 24%, very good partial response or better 
      (>/=VGPR) rate of 67%, overall response rate (ORR) of 92%. Daratumumab added to 
      standard of care significantly improved progression free survival (PFS): the HR 
      for PFS was 0.52 [0.44, 0.61], P < .001. The HR for overall survival (OS) was 
      0.73 [0.52, 1.04], P = .09. In the network meta-analysis for patients ineligible 
      for autologous stem-cell transplantation (ASCT), DRd regimen produced significant 
      PFS advantage vs other first-line treatments (VMP HR:0.39 P < .001, Rd HR:0.55 
      P < .001, MPT HR:0.38 P < .001, and MP HR:0.22 P < .001); DVMP regimen also 
      produced significant PFS advantage vs VMP (HR:0.50 P < .001), MPT (HR:0.49 
      P < .001), and MP (HR:0.28 P < .001). Among these first-line regimens (DRd, DVMP, 
      VMP, Rd, MPT, and MP), DRd regimen had the highest probability to be the best 
      intervention, with 83.4% and 91.0% probability to reach the longest PFS and OS, 
      respectively. Toxicity consisted primarily of myelosuppression. And, the vital 
      non-hematologic adverse events (AEs) were peripheral sensory neuropathy (41% of 
      all grades) and upper respiratory tract infection (39% of all grades). 
      CONCLUSIONS: Daratumumab added to standard of care could produce clinical 
      benefits in newly diagnosed patients with multiple myeloma. DRd and DVMP could be 
      good combination options for those patients ineligible for ASCT.
CI  - (c) 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Xu, Wenjun
AU  - Xu W
AD  - Department of Hematology, Weifang People's Hospital, Weifang, China.
FAU - Li, DianFang
AU  - Li D
AD  - Department of Hematology, Weifang People's Hospital, Weifang, China.
FAU - Sun, Yanhua
AU  - Sun Y
AD  - Department of Hematology, Weifang People's Hospital, Weifang, China.
FAU - Ran, Xuehong
AU  - Ran X
AD  - Department of Hematology, Weifang People's Hospital, Weifang, China.
FAU - Wang, Baohong
AU  - Wang B
AD  - Department of Hematology, Weifang People's Hospital, Weifang, China.
FAU - Wu, Wei
AU  - Wu W
AD  - Department of Stomatology, Weifang People's Hospital, Weifang, China.
FAU - Sheng, Zhixin
AU  - Sheng Z
AUID- ORCID: 0000-0001-9986-7875
AD  - Department of Hematology, Weifang People's Hospital, Weifang, China.
FAU - Liu, Liping
AU  - Liu L
AD  - Department of Hematology, Weifang People's Hospital, Weifang, China.
LA  - eng
GR  - 2018YX049/Science and Technology Development Program of Weifang/
GR  - 2018YX004/Science and Technology Development Program of Weifang/
GR  - ZR2017BH116/Shandong Provincial Natural Science Foundation/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20191001
PL  - England
TA  - Eur J Haematol
JT  - European journal of haematology
JID - 8703985
RN  - 0 (Antibodies, Monoclonal)
RN  - 4Z63YK6E0E (daratumumab)
SB  - IM
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Autografts
MH  - Clinical Trials as Topic
MH  - Disease-Free Survival
MH  - Humans
MH  - Multiple Myeloma/mortality/*therapy
MH  - Stem Cell Transplantation
MH  - Survival Rate
OTO - NOTNLM
OT  - daratumumab
OT  - front-line
OT  - meta-analysis
OT  - multiple myeloma
EDAT- 2019/08/25 06:00
MHDA- 2020/03/27 06:00
CRDT- 2019/08/25 06:00
PHST- 2019/07/02 00:00 [received]
PHST- 2019/08/14 00:00 [revised]
PHST- 2019/08/16 00:00 [accepted]
PHST- 2019/08/25 06:00 [pubmed]
PHST- 2020/03/27 06:00 [medline]
PHST- 2019/08/25 06:00 [entrez]
AID - 10.1111/ejh.13317 [doi]
PST - ppublish
SO  - Eur J Haematol. 2019 Dec;103(6):542-551. doi: 10.1111/ejh.13317. Epub 2019 Oct 1.