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Thalidomide for previously untreated elderly patients with multiple myeloma: meta-analysis of 1685 individual patient data from 6 randomized clinical trials

Fayers, Peter M.; Palumbo, Antonio; Hulin, Cyrille; Waage, Anders; Wijermans, Pierre; Beksac, Meral; Bringhen, Sara; Mary, Jean-Yves; Gimsing, Peter and Termorshuizen, Fabian, et al. (2011) In Blood 118(5). p.1239-1247
Abstract
The role of thalidomide for previously untreated elderly patients with multiple myeloma remains unclear. Six randomized controlled trials, launched in or after 2000, compared melphalan and prednisone alone (MP) and with thalidomide (MPT). The effect on overall survival (OS) varied across trials. We carried out a meta-analysis of the 1685 individual patients in these trials. The primary endpoint was OS, and progression-free survival (PFS) and 1-year response rates were secondary endpoints. There was a highly significant benefit to OS from adding thalidomide to MP (hazard ratio = 0.83; 95% confidence interval 0.73-0.94, P = .004), representing increased median OS time of 6.6 months, from 32.7 months (MP) to 39.3 months (MPT). The thalidomide... (More)
The role of thalidomide for previously untreated elderly patients with multiple myeloma remains unclear. Six randomized controlled trials, launched in or after 2000, compared melphalan and prednisone alone (MP) and with thalidomide (MPT). The effect on overall survival (OS) varied across trials. We carried out a meta-analysis of the 1685 individual patients in these trials. The primary endpoint was OS, and progression-free survival (PFS) and 1-year response rates were secondary endpoints. There was a highly significant benefit to OS from adding thalidomide to MP (hazard ratio = 0.83; 95% confidence interval 0.73-0.94, P = .004), representing increased median OS time of 6.6 months, from 32.7 months (MP) to 39.3 months (MPT). The thalidomide regimen was also associated with superior PFS (hazard ratio = 0.68, 95% confidence interval 0.61-0.76, P < .0001) and better 1-year response rates (partial response or better was 59% on MPT and 37% on MP). Although the trials differed in terms of patient baseline characteristics and thalidomide regimens, there was no evidence that treatment affected OS differently according to levels of the prognostic factors. We conclude that thalidomide added to MP improves OS and PFS in previously untreated elderly patients with multiple myeloma, extending the median survival time by on average 20%. (Blood. 2011;118(5):1239-1247) (Less)
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Blood
volume
118
issue
5
pages
1239 - 1247
publisher
American Society of Hematology
external identifiers
  • wos:000293510000015
  • scopus:80051570906
ISSN
1528-0020
DOI
10.1182/blood-2011-03-341669
language
English
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yes
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6699073e-ab87-42e8-b798-d80c224f14c4 (old id 2071666)
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2011-09-02 08:28:19
date last changed
2017-10-01 03:28:05
@article{6699073e-ab87-42e8-b798-d80c224f14c4,
  abstract     = {The role of thalidomide for previously untreated elderly patients with multiple myeloma remains unclear. Six randomized controlled trials, launched in or after 2000, compared melphalan and prednisone alone (MP) and with thalidomide (MPT). The effect on overall survival (OS) varied across trials. We carried out a meta-analysis of the 1685 individual patients in these trials. The primary endpoint was OS, and progression-free survival (PFS) and 1-year response rates were secondary endpoints. There was a highly significant benefit to OS from adding thalidomide to MP (hazard ratio = 0.83; 95% confidence interval 0.73-0.94, P = .004), representing increased median OS time of 6.6 months, from 32.7 months (MP) to 39.3 months (MPT). The thalidomide regimen was also associated with superior PFS (hazard ratio = 0.68, 95% confidence interval 0.61-0.76, P &lt; .0001) and better 1-year response rates (partial response or better was 59% on MPT and 37% on MP). Although the trials differed in terms of patient baseline characteristics and thalidomide regimens, there was no evidence that treatment affected OS differently according to levels of the prognostic factors. We conclude that thalidomide added to MP improves OS and PFS in previously untreated elderly patients with multiple myeloma, extending the median survival time by on average 20%. (Blood. 2011;118(5):1239-1247)},
  author       = {Fayers, Peter M. and Palumbo, Antonio and Hulin, Cyrille and Waage, Anders and Wijermans, Pierre and Beksac, Meral and Bringhen, Sara and Mary, Jean-Yves and Gimsing, Peter and Termorshuizen, Fabian and Haznedar, Rauf and Caravita, Tommaso and Moreau, Philippe and Turesson, Ingemar and Musto, Pellegrino and Benboubker, Lotfi and Schaafsma, Martijn and Sonneveld, Pieter and Facon, Thierry},
  issn         = {1528-0020},
  language     = {eng},
  number       = {5},
  pages        = {1239--1247},
  publisher    = {American Society of Hematology},
  series       = {Blood},
  title        = {Thalidomide for previously untreated elderly patients with multiple myeloma: meta-analysis of 1685 individual patient data from 6 randomized clinical trials},
  url          = {http://dx.doi.org/10.1182/blood-2011-03-341669},
  volume       = {118},
  year         = {2011},
}