文章：

滤泡性淋巴瘤一线免疫化疗疗效：随机对照试验的网络荟萃分析

Efficacy of front-line immunochemotherapy for follicular lymphoma: a network meta-analysis of randomized controlled trials

原文发布日期：2022-01-05

DOI: 10.1038/s41408-021-00598-x

类型: Article

开放获取: 是

英文摘要：

Front-line treatment for follicular lymphoma has evolved with the introduction of maintenance therapy, bendamustine (Benda), obinutuzumab (G), and lenalidomide (Len). We conducted a random-effects Bayesian network meta-analysis (NMA) of phase 3 randomized controlled trials (RCTs) to identify the regimens with superior efficacy. Progression-free survival (PFS) was compared between 11 modern regimens with different immunochemotherapy and maintenance strategies. G-Benda-G resulted in with the best PFS, with an HR of 0.41 compared to R-Benda, a surface under the cumulative ranking curve (SUCRA) of 0.97, a probability of being the best treatment (PbBT) of 72%, and a posterior ranking distribution (PoRa) of 1 (95% BCI 1–3). This was followed by R-Benda-R4 (HR = 0.49, PbBT = 25%, PoRa = 2) and R-Benda-R (HR = 0.60, PbBT = 3%, PoRa = 3). R-CHOP-R (HR = 0.96) and R-Len-R (HR = 0.97) had similar efficacy to R-Benda. Bendamustine was a better chemotherapy backbone than CHOP either with maintenance (R-Benda-R vs R-CHOP-R, HR = 0.62; G-Benda-G vs G-CHOP-G, HR = 0.55) or without maintenance therapy (R-Benda vs R-CHOP, HR = 0.68). Rituximab maintenance improved PFS following R-CHOP (R-CHOP-R vs R-CHOP, HR = 0.65) or R-Benda (R-Benda-R vs R-Benda, HR = 0.60; R-Benda-R4 vs R-Benda, HR = 0.49). In the absence of multi-arm RCTs that include all common regimens, this NMA provides an important and useful guide to inform treatment decisions.
 

摘要翻译： 

滤泡性淋巴瘤的一线治疗随着维持疗法、苯达莫司汀（Benda）、奥妥珠单抗（G）和来那度胺（Len）的引入而不断发展。我们对3期随机对照试验进行了随机效应贝叶斯网络荟萃分析，以确定疗效更优的治疗方案。本研究比较了11种采用不同免疫化疗及维持策略的现代治疗方案的无进展生存期。结果显示，G-Benda-G方案的无进展生存期最佳，与利妥昔单抗联合苯达莫司汀方案相比风险比为0.41，累积排序曲线下面积为0.97，成为最佳治疗的概率为72%，后验排名分布为1（95%贝叶斯可信区间1–3）。其次是R-Benda-R4方案（风险比=0.49，最佳治疗概率=25%，后验排名=2）和R-Benda-R方案（风险比=0.60，最佳治疗概率=3%，后验排名=3）。R-CHOP-R方案（风险比=0.96）和R-Len-R方案（风险比=0.97）与R-Benda方案的疗效相近。无论是联合维持治疗（R-Benda-R对比R-CHOP-R，风险比=0.62；G-Benda-G对比G-CHOP-G，风险比=0.55）还是不联合维持治疗（R-Benda对比R-CHOP，风险比=0.68），苯达莫司汀作为化疗基础方案均优于CHOP方案。利妥昔单抗维持治疗可改善R-CHOP方案（R-CHOP-R对比R-CHOP，风险比=0.65）或R-Benda方案后的无进展生存期（R-Benda-R对比R-Benda，风险比=0.60；R-Benda-R4对比R-Benda，风险比=0.49）。在缺乏包含所有常规方案的多臂随机对照试验的情况下，本项网络荟萃分析为治疗决策提供了重要且实用的指导。

原文链接：

Efficacy of front-line immunochemotherapy for follicular lymphoma: a network meta-analysis of randomized controlled trials