Efficacy And Safety Of Elotuzumab In The Treatment Of Relapsed/refractory Multiple Myeloma:Meta Analysis

Objective:Meta analysis was used to evaluate the efficacy and safety of elotuzumab in the treatment of relapsed/refractory multiple myeloma.Methods:Using the computer search Pubmed,the Cochrane Library,Embase,web of science,CNKI,Wang fang medical databases,The starting time is to build the database,and the deadline is September 2020.from which the Ⅰ-Ⅲ phase of clinical trial on the treatment RRMM of elotuzumab was selected,Quality assessment and data extraction were performed by two researchers independently in those studies in line with the inclusion criteria and exclusion criteria.Study author or name,the stage of clinical trial,year of publication,number of cases,number of men,intervention measures,overall response rate,Median progression-free,the numbers of complete response、very good partial response or better、partial response 、progressive disease,common adverse reactions,and the 95% confidence interval were extracted.Randomized controlled trials(RCT)were conducted to extract the above data from the control group.Then Stata16.0software was used for data analysis.Results:1.Six trials were finally included,involving a total of 1045 patients.A total of 4randomized controlled trials were conducted,one of which was a randomized controlled trial of elotuzumab at different doses.2.The results showed that the combined ORR,CR+SCR,VGPR,PR,and PD of errotuzumab in the treatment of RRMM were 78%,5%,28%,37%and 3% respectively.Subgroup analysis showed that ORR(78% vs 53%),VGPR(31% vs 12%),and PR(38%vs 33%)were significantly higher in RRMM patients who had previously received a 1-3line treatment than those who had previously received a mean 3-line treatment,with less disease progression(3% vs 12%).The incidence of infection was the highest in 72% of all grades of adverse reactions,including fever(32%),cough(33%),upper respiratory tract(29%)and acute pneumonia(15%).Hematological adverse reactions were followed by anemia(51%),lymphocytopenia(50%),neutropenia(43%),and thrombocytopenia(38%).Gastrointestinal symptoms were also common,with constipation in 37% and diarrhea in 48%.Systemic symptoms such as fatigue were 46%,insomnia 25%,other adverse reactions such as muscle spasms 34%,bone pain and peripheral neuritis 33%,hyperglycemia 32%,and back pain 15%.Among the grade 3-4 adverse reactions,hematological adverse reactions ranked first,anemia was 11%,lymphocytopenia was34%,neutropenia was 22%,and thrombocytopenia was 14%.The second most common cases were infection(23%),fever(3%),cough(0%),upper respiratory tract infection(3%)and acute pneumonia(9%).Symptoms such as fatigue were 8%,insomnia 2%,and other adverse reactions such as muscle cramps 3%,bone pain 3%,hyperglycemia 9%,and back pain 5%.3.Three randomized controlled trials were select to observe the effect of elotuzumab addition on the original protocol.The results showed that the relative risk(RR)of ORR was 1.22,the RR of VGPR was 1.40,and the RR of PR was 1.20.P <0.05,and the differences were statistically significant.It was suggested that the addition of elotuzumab improved the ORR,VGPR and PR of patients.Compared with grade 3-4 adverse reactions,It was suggested that elotuzumab reduced the incidence of neutropenia and increased the incidence of infection and lymphocytopenia.Conclusion:1.Elotuzumab combined with chemotherapy has a high remission rate in the treatment of RRMM.2.The number of previous treatment lines is closely related to the therapeutic response of RRMM patients to elotuzumab.3.The incidence of errotuzumab adverse events is generally high,the most common being infection and hemocytosis.4.The addition of errotuzumab into primary chemotherapy significantly improved the ORR,VGPR and PR of RRMM patients,reduced the incidence of grade 3-4neutropenia,and increased the incidence of infection and lymphocytopenia.