The Efficacy And Safety Of Daratumumab In The Treatment Of Multiple Myeloma: Meta-analysis

Objective:To systematically review the efficacy and safety of Daratumumab monoclonal antibody in the treatment of multiple myeloma.Find effective and safe treatment options for MM patients.Methods:CNKI?CBM?Wanfang?VIP?PubMed? web of science ?ClinicalTrials.gov databases were searched to collect studies about Daratumumab in the treatment of multiple myeloma from January 2015 to August 2019.Reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,a meta-analysis was performed by stata 12.0 \Revman 5.3 software.Results:A total of 17 studies were included,with 2511 patients enrolled.The results of Meta analysis showed that the treatment plan with Daratumumab can significantly increase the ORR,CR,negative rate of MRD and the prolongation of PFS in patients with multiple myeloma compared with the treatment plan without Daratumumab.The Meta-analysis showed that the number of previous treatments was the most important factor affecting the clinical overall response rate.The overall response rate of MM patients who have not been treated with Daratumumab before and after one treatment is as high as 90% [95% CI(0.873,0.928)].The overall response rate of MM patients who received 2-4 treatments before Daratumumab treatment was 52.0% [95% CI(0.319,0.721)].The overall response rate of MM patients who have received at least 4treatments before Daratumumab treatment was 38.5% [95% CI(0.130,0.640)].In terms of safety,the treatment plan with Daratumumab has a lower risk of anemia than the treatment plan without Dara,but the risk of neutropenia,lymphopenia,and upper respiratory tract infection is higher..The incidence of specific infusion reactions was33.3% [95% CI(0.266,0.393)].Conclusion:1.Daratumumab-containing treatment for MM can increase the ORR,CR,MRD negative rate of MM and is beneficial to prolong PFS in patients with multiple myeloma;2.The line of previous treatments is the most important factor affecting the overall clinical response rate.Patients with MM who have not previously been treated and after a single treatment can benefit significantly from Daratumumab treatment.And as the line of treatments increases,the overall response rate of treatment will gradually decrease;3.Daratumumab treatment of MM has a higher incidence of neutropenia,lymphopenia,and upper respiratory tract infections.Specific infusion reactions are also common,but they are mild and easy to control.