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Abstract
During the past decades, many novel agents have improved response and survival of patients with multiple myeloma. Nevertheless, it remains challenging when they suffer relapsing. Thus, novel therapeutic agents are needed. We aimed to assess the efficacy and safety of a novel agent panobinostat for patients with relapsed or/and refractory MM. A systematic literature review identified studies for clinical trials about panobinostat in patients with relapsed or/and refractory MM. We searched studies published between January 2000 and December 2015 in Pubmed, Ovid, EBSCO and the Cochrane library. Random-effect pooled estimates were calculated for overall response rate and rates of common adverse effects. The results showed 11 clinical trials including 700 patients with relapsed or/and refractory MM treated with panobinostat were identified. The ORR varied between 0.08 and 0.67. Pooled analyses showed the results that the ORR was 0.45 (95% CI: 0.31–0.59, I2 = 90.5%, P = 0.000) for panobinostat combined with any other kind of drugs. The most common Grade3/4 adverse effects were thrombocytopenia, neutropenia, lymphopenia, anemia, diarrhea, fatigue, nausea and so on. In conclusion, based on our analyses, the regimen of panobinostat combining with other agents seems to be well tolerated and efficacious in patients with relapsed or/and refractory MM.
Highlights
Multiple myeloma (MM) is a malignant neoplasm of plasma cells that accumulate in bone marrow, leading to hypercalcemia, renal failure, anemia, osteolytic bone lesions and so on[1,2]
We explored overall response rate (ORR), CBR and rates of SD, PD and AEs using 95% confidence interval (CI) for panobinostat combined with any agents and with proteasome inhibitor separately
The characteristics and previous treatments of the studies are shown in Tables 1 and 2. 8 studies were trials about ponobinostat combined with proteasome inhibitor, and 5 of them were combined with both bortezomib and dexamethasone. 1 combined with lenalidomide and dexamethasone, 1 combined with melphalan and 1 combined
Summary
Multiple myeloma (MM) is a malignant neoplasm of plasma cells that accumulate in bone marrow, leading to hypercalcemia, renal failure, anemia , osteolytic bone lesions and so on[1,2]. The current treatment is based on a combination of CCs with PIs and/or ImiDs. According to patient age and performance status, this therapy may be followed by stem cell autologous transplantation[3]. According to patient age and performance status, this therapy may be followed by stem cell autologous transplantation[3] These novel agents significantly improved the response rate, progression-free survival, and overall survival over the last decade, and made it easy to control the disease for longer periods of time[4]. Despite these advances, most MM patients relapse, even those who experience a complete response to initial therapy[5,6,7]. Our meta analyses focus on the efficacy and safety of panobinostat combined with other agents in patients with relapsed or/and refractory MM
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