Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis
Abstract Background Daratumumab (Dara)-based regimens have been investigated in randomized controlled trials (RCTs) involving patients with newly diagnosed and previously untreated multiple myeloma (NDMM), but the optimal daratumumab-based regimen remains unclear. This study compares the efficacy of...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | Systematic Reviews |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13643-025-02804-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850132766642929664 |
|---|---|
| author | Xiaohua Huang Jia Zhou Yuxiao Qian Jing He Lu Yang Zhigang Wang Diu Wei Mengjie Li Wei Ma Haiyan Lang |
| author_facet | Xiaohua Huang Jia Zhou Yuxiao Qian Jing He Lu Yang Zhigang Wang Diu Wei Mengjie Li Wei Ma Haiyan Lang |
| author_sort | Xiaohua Huang |
| collection | DOAJ |
| description | Abstract Background Daratumumab (Dara)-based regimens have been investigated in randomized controlled trials (RCTs) involving patients with newly diagnosed and previously untreated multiple myeloma (NDMM), but the optimal daratumumab-based regimen remains unclear. This study compares the efficacy of daratumumab-containing regimens for NDMM patients and explores optimal combinations. Methods Databases were searched from inception until February 29, 2024. Trials comparing regimens with and without daratumumab, as well as their mutual comparisons, were included. Random effects models for serious adverse events (SAEs) and fixed effects models for other outcomes were utilized in both network meta-analysis (NMA) and component NMA (CNMA), with pooled effects estimated. The efficacy of all possible combinations of daratumumab with other drugs was assessed. Results A total of 17 trials were included, enrolling 7261 patients, of whom 2083 were treated with daratumumab. The optimal regimens for different outcomes were identified as follows: Dara-bortezomib (V)-melphalan (M)-corticosteroids (D) (Dara-VMD) showed the best results for both overall response rate (ORR) [RR = 1.97; 95% CI: 1.42 to 2.75; I 2 = 0.00%; 16 trials; 7136 participants; P = 0.00] and ≥ very good partial response (≥ VGPR) [RR = 7.46; 95% CI: 4.10 to 13.46; I 2 = 23.96%; 16 trials; 7118 participants; P = 0.00]; Dara-V-thalidomide (T)-D (Dara-VTD) was optimal for achieving ≥ complete response (≥ CR) [RR = 14.15; 95% CI: 3.74 to 53.52; I 2 = 0.00%; 17 trials; 7261 participants; P = 0.00]. The individual effects of daratumumab were calculated as follows: [ORR: RR = 1.14; 95% CI: 1.08 to 1.21; I 2 = 0.00%; 16 trials; 7136 participants; P = 0.00; ≥ VGPR: RR = 1.46; 95% CI: 1.36 to 1.58; I 2 = 23.96%; 16 trials; 7118 participants; P = 0.00; ≥ CR: RR = 1.77; 95% CI: 1.55 to 1.99; I 2 = 0.00; 17 trials; 7261 participants; P = 0.00; progression-free survival (PFS): hazard ratio (HR) = 0.53; 95% CI: 0.43 to 0.65; I 2 = 0.00%; 13 trials; 5977 participants; P = 0.00; overall survival (OS): HR = 0.68; 95% CI: 0.58 to 0.79; I 2 = 28.97%; 12 trials; 5977 participants; P = 0.00]. Additionally, the optimal regimens for PFS and OS were Dara-lenalidomide (R)-D [HR = 0.37; 95% CI: 0.23 to 0.61; I 2 = 0.00%; 13 trials; 5977 participants; P = 0.00] and Dara-VRD [HR = 0.40; 95% CI: 0.19 to 0.85; I 2 = 28.97%; 12 trials; 5977 participants; P = 0.02], respectively. Finally, CNMA indicated that Dara-VRD, Dara-carfilzomib (K)-RD, Dara-RD, and Dara-cyclophosphamide (C)-RD were four regimens, which could improve remission rate, and reduce death or progression during induction and prolong lifetime. Conclusions Dara-VRD, Dara-KRD, Dara-RD, and Dara-CRD are optimal daratumumab-based regimens for patients with newly diagnosed and previously untreated multiple myeloma. |
| format | Article |
| id | doaj-art-86c41ba1407e4f99804f2cccc9fcaf06 |
| institution | OA Journals |
| issn | 2046-4053 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj-art-86c41ba1407e4f99804f2cccc9fcaf062025-08-20T02:32:08ZengBMCSystematic Reviews2046-40532025-05-0114111310.1186/s13643-025-02804-4Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysisXiaohua Huang0Jia Zhou1Yuxiao Qian2Jing He3Lu Yang4Zhigang Wang5Diu Wei6Mengjie Li7Wei Ma8Haiyan Lang9Haematology Department, Dongzhimen Hospital, Beijing University of Chinese MedicineThe First Clinical Medical College, Guangzhou University of Chinese MedicineThe First Clinical Medicine College, Beijing University of Chinese MedicineHaematology Department, The First Affiliated Hospital of Guangzhou University of Traditional Chinese MedicineHaematology Department, Dongzhimen Hospital, Beijing University of Chinese MedicineHaematology Department, Dongzhimen Hospital, Beijing University of Chinese MedicineHaematology Department, Dongzhimen Hospital, Beijing University of Chinese MedicineHaematology Department, Dongzhimen Hospital, Beijing University of Chinese MedicineHaematology Department, Dongzhimen Hospital, Beijing University of Chinese MedicineHaematology Department, Dongzhimen Hospital, Beijing University of Chinese MedicineAbstract Background Daratumumab (Dara)-based regimens have been investigated in randomized controlled trials (RCTs) involving patients with newly diagnosed and previously untreated multiple myeloma (NDMM), but the optimal daratumumab-based regimen remains unclear. This study compares the efficacy of daratumumab-containing regimens for NDMM patients and explores optimal combinations. Methods Databases were searched from inception until February 29, 2024. Trials comparing regimens with and without daratumumab, as well as their mutual comparisons, were included. Random effects models for serious adverse events (SAEs) and fixed effects models for other outcomes were utilized in both network meta-analysis (NMA) and component NMA (CNMA), with pooled effects estimated. The efficacy of all possible combinations of daratumumab with other drugs was assessed. Results A total of 17 trials were included, enrolling 7261 patients, of whom 2083 were treated with daratumumab. The optimal regimens for different outcomes were identified as follows: Dara-bortezomib (V)-melphalan (M)-corticosteroids (D) (Dara-VMD) showed the best results for both overall response rate (ORR) [RR = 1.97; 95% CI: 1.42 to 2.75; I 2 = 0.00%; 16 trials; 7136 participants; P = 0.00] and ≥ very good partial response (≥ VGPR) [RR = 7.46; 95% CI: 4.10 to 13.46; I 2 = 23.96%; 16 trials; 7118 participants; P = 0.00]; Dara-V-thalidomide (T)-D (Dara-VTD) was optimal for achieving ≥ complete response (≥ CR) [RR = 14.15; 95% CI: 3.74 to 53.52; I 2 = 0.00%; 17 trials; 7261 participants; P = 0.00]. The individual effects of daratumumab were calculated as follows: [ORR: RR = 1.14; 95% CI: 1.08 to 1.21; I 2 = 0.00%; 16 trials; 7136 participants; P = 0.00; ≥ VGPR: RR = 1.46; 95% CI: 1.36 to 1.58; I 2 = 23.96%; 16 trials; 7118 participants; P = 0.00; ≥ CR: RR = 1.77; 95% CI: 1.55 to 1.99; I 2 = 0.00; 17 trials; 7261 participants; P = 0.00; progression-free survival (PFS): hazard ratio (HR) = 0.53; 95% CI: 0.43 to 0.65; I 2 = 0.00%; 13 trials; 5977 participants; P = 0.00; overall survival (OS): HR = 0.68; 95% CI: 0.58 to 0.79; I 2 = 28.97%; 12 trials; 5977 participants; P = 0.00]. Additionally, the optimal regimens for PFS and OS were Dara-lenalidomide (R)-D [HR = 0.37; 95% CI: 0.23 to 0.61; I 2 = 0.00%; 13 trials; 5977 participants; P = 0.00] and Dara-VRD [HR = 0.40; 95% CI: 0.19 to 0.85; I 2 = 28.97%; 12 trials; 5977 participants; P = 0.02], respectively. Finally, CNMA indicated that Dara-VRD, Dara-carfilzomib (K)-RD, Dara-RD, and Dara-cyclophosphamide (C)-RD were four regimens, which could improve remission rate, and reduce death or progression during induction and prolong lifetime. Conclusions Dara-VRD, Dara-KRD, Dara-RD, and Dara-CRD are optimal daratumumab-based regimens for patients with newly diagnosed and previously untreated multiple myeloma.https://doi.org/10.1186/s13643-025-02804-4DaratumumabNewly diagnosedMultiple myelomaLenalidomideComponent network meta-analysis |
| spellingShingle | Xiaohua Huang Jia Zhou Yuxiao Qian Jing He Lu Yang Zhigang Wang Diu Wei Mengjie Li Wei Ma Haiyan Lang Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis Systematic Reviews Daratumumab Newly diagnosed Multiple myeloma Lenalidomide Component network meta-analysis |
| title | Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis |
| title_full | Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis |
| title_fullStr | Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis |
| title_full_unstemmed | Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis |
| title_short | Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis |
| title_sort | optimal daratumumab based regimen for patients with newly diagnosed and previously untreated multiple myeloma systematic review and component network meta analysis |
| topic | Daratumumab Newly diagnosed Multiple myeloma Lenalidomide Component network meta-analysis |
| url | https://doi.org/10.1186/s13643-025-02804-4 |
| work_keys_str_mv | AT xiaohuahuang optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT jiazhou optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT yuxiaoqian optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT jinghe optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT luyang optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT zhigangwang optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT diuwei optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT mengjieli optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT weima optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis AT haiyanlang optimaldaratumumabbasedregimenforpatientswithnewlydiagnosedandpreviouslyuntreatedmultiplemyelomasystematicreviewandcomponentnetworkmetaanalysis |