Comparative Efficacy of Treatment Regimens for Transplant-Ineligible Patients with Newly Diagnosed Multiple Myeloma

Introduction

Multiple myeloma (MM) treatment has evolved, especially for patients ineligible for stem cell transplantation due to age or comorbidities. This study aimed to compare the efficacy of different therapies for these patients through a network meta-analysis (NMA).

Methods

The NMA included data from large randomized controlled trials (RCTs) such as SWOG S0777, ENDURANCE, MAIA, and ALCYONE. It focused on progression-free survival (PFS) and overall survival (OS), using lenalidomide/dexamethasone (Rd) as the reference comparator.

Results

Daratumumab-containing treatments (D-Rd, D-VMP) and bortezomib/lenalidomide/dexamethasone (VRd) showed the highest probabilities of being more effective than Rd for both PFS and OS. D-Rd was ranked as the most effective treatment.

Conclusions

The findings suggest that D-Rd, D-VMP, and VRd are the most effective treatments for improving PFS and OS in transplant-ineligible patients with newly diagnosed multiple myeloma. This analysis may guide treatment selection for this patient population.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12325-022-02083-8.