肿瘤细胞治疗研究
英文原题：Relapsed and refractory multiple myeloma: A systematic review and network meta-analysis of the efficacy of novel therapies.
主要终点为无进展生存期（PFS），以风险比（HR）及95%置信区间（95% CI）评估，并与地塞米松（DEX）进行比较。
多发性骨髓瘤（MM）的预后随着新药的开发而显著改善，确定这些新型药物的适当组合已变得非常重要。本研究是对复发和/或难治性（RR）MM患者随机试验的系统评价和网络meta分析（NMA）。检索了PubMed、Cochrane和Embase数据库中2002年1月1日至2022年2月28日期间接受MM治疗的患者的随机试验。主要终点为无进展生存期（PFS），以与地塞米松（DEX）相比的风险比（HR）及95%置信区间（95% CI）进行评估。采用p-score对治疗进行排名。在总共筛选的1136篇摘要中，选择了37项研究，包括34种RRMM治疗方案。达雷妥尤单抗、来那度胺和DEX被发现在RRMM中为最佳治疗，与DEX相比具有最佳HR（HR，0.13；95% CI，0.08-0.20；p-score 0.9796）。没有显著异质性的证据（I 2，41.3%；p = 0.146）。当前的NMA证实了包含抗CD38抗体的三药方案治疗RRMM的卓越疗效，并为评估CAR-T 细胞治疗和双特异性T细胞衔接器治疗的疗效提供了背景数据。
The prognosis of multiple myeloma (MM) has dramatically improved with the development of new drugs, and it has become important to determine the appropriate combinations of these novel agents. This study was a systematic review and network meta-analysis (NMA) of randomized trials in patients with relapsed and/or refractory (RR) MM. The PubMed, Cochrane, and Embase databases were searched for randomized trials from 1 January 2002 to 28 February 2022 of patients treated for MM. The primary end-point was progression-free survival (PFS), evaluated as a hazard ratio (HR) with a 95% confidence interval (95% CI) compared to dexamethasone (DEX). The p-score was used to rank treatments. Of a total of 1136 abstracts screened, 37 studies were selected, including 34 treatment options for RRMM. Daratumumab, lenalidomide and DEX was found to be the best treatment for RRMM, with the best HR compared to DEX (HR, 0.13; 95% CI, 0.08-0.20; p-score 0.9796). There was no evidence of significant heterogeneity (I 2 , 41.3%; p = 0.146). The current NMA confirmed the excellent efficacy of three-drug regimens including anti-CD38 antibodies to treat RRMM and provides background data to evaluate the efficacy of chimeric antigen receptor T-cell treatments and bispecific T-cell engager therapies.
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