Efficacy And Safety Of Lenalidomide For Treating The Newly Diagnosed Multiple Myeloma:A Meta-analysis

Objective:To System evaluation overseas published about efficacy and safety of lenalido mide MDT for treating the newly diagnosed multiple myeloma.Methods:Throughing CNKI,CBM,Wan-fang data,VIP,Medline,PubMed and ClinicalTrials.Gov database in both English and Chinese,retrieved from the database set until J anuary 2017.Search keywords:the newly diagnosed multiple myeloma or the untrea ted multiple myeloma,Immune modulators,lenalidomide.Retrieve clinical trial docum ents published about lenalidomide treating the newly diagnosed MM,extracting dat as including CR/VGPR?OR??PFS?OS and drug adverse reactions.Merging effect and using RevMan 5.3 software to analysis.Results:A total of 6 articles were included,a total of 1449 participants,lenalidomide group 820,control group of 619 people,of which 4 papers of lenalidomide and placebo,2 lenalidomide and thalidomide in comparison1.The CR/VGPR rate and OR rate in the lenalidomide group were higher than those in the control group[OR=3.66,95%CI(2.87,4.66),P<0.00001,P<0.05;OR=2.47,95%CI(1.99,3.05),P<0.00001,P<0.05].2.The 1 year and 20 months of PFS for lenalidomide in treating the newly diagnosed MM were longer than those of thalidomide[OR=2.25,95%CI(1.81,2.79),P<0.00001,P<0.05;OR=1.74,95%CI(1.40,1.2.16),P<0.00001,P<0.05]?3.The 1 years and 20 months OS were not only in the comparison between lenalidomide group and control group but also in that subgroup comparison of thalidomide,The results were similar[vs control group,OR=1.19,95%CI(0.84,1.69),P=0.32,P>0.05;OR=0.85,95%CI(0.65,1.12),P=0.25,P>0.05;vs thalidomide,OR=1.30,95%CI(0.82,2.06),P=0.27,P>0.05;OR=0.90,95%CI(0.63,1.27),P=0.54,P>0.05].4.In terms of the security,the adverse reaction of lenalidomide group was mainly hematologic toxicitiy[OR=1.98,95%CI(1.77,2.21),P<0.05];Mainly include anemia,neutropenia,thrombocytopenia(P=0.0003,P<0.00001,P<0.0001,P all lower0.05);And in the lenalidomide group,neurological symptoms had an Obviously lower incidence(P=<0.00001).Conclusion:1.Lenalidomide MDT has higher rate of CR/VGPR OR in treating the newly diagnosed MM;2.Lenalidomide MDT could prolong PFS of the newly diagnosed MM,but can not make the OS benefit;3.The safety of lenalidomide MDT was high,the adverse reaction was mainly hematological toxicity,and the risk of nervous system lesion was low;4.Lenalidomide MDT is an ideal drug for the treatment of newly diagnosed MM patients.