A Bayesian Network Meta-Analysis Comparing the Efficacies of Eleven Novel Therapies with the Common Salvage Regimen for Relapsed or Refractory Acute Myeloid Leukemia
A Bayesian Network Meta-Analysis Comparing the Efficacies of Eleven Novel Therapies with the Common Salvage Regimen for Relapsed or Refractory Acute Myeloid Leukemia
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贝叶斯网络荟萃分析比较 11 种新疗法与常见挽救方案治疗复发或难治性急性髓系白血病的疗效
DOI：
10.1159/000493494
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发表时间：
2018-09
影响因子：
--
通讯作者：
Chunsen Wang
中科院分区：
文献类型：
--
作者：
Juan Huang;Chunxue Gui;Lei Zhang;Feifei Che;Chunsen Wang
背景与目的：急性髓细胞白血病（AML）是一种复发性、难治性血液系统恶性肿瘤，发病率低，但死亡率高。除了造血干细胞移植，化疗被用作一线治疗。然而，可用药物的多样性和相关试验结果的不一致性使治疗决策变得坚韧。网络荟萃分析（NMA）是一种有效的统计框架，可以进行全面的比较，并提供有价值的临床参考。方法：从医学数据库中检索所有潜在试验，并根据纳入和排除标准进行筛选。提取每个试验的主要特征以及主要结局，包括完全缓解（CR）、总缓解率（ORR）、总生存期（OS）和无事件生存期（EFS）。此外，还绘制了网络图，以说明所涉及的试验之间的联系。网络中的比较结果显示在森林图中。此外，引入累积排序曲线下面（SUCRA）对每个终点的治疗进行排序。结果：从1,625个鉴定中，共筛选出11个试验。对于终点CR和ORR，未观察到共同治疗的显著差异。在操作系统方面，CPX-351（HR：0.77，95% CrI：0.63，0.94）和HiDAC + MK-8776（HR：0.80，95% CrI：0.68，0.93）显示在短期内优于普通挽救治疗方案，而HiDAC + MK-8776（HR：0.80，95% CrI：0.70，0.93）和阿糖胞苷加伏沙菌素（HR：0.86，95% CrI：0.74，0.99）优于常用的挽救方案的3年OS。（HR：0.61，95%CrI：0.53，0.69）和CPX-351（HR：0.71，95%CrI：0.60，0.83）被证实在提高EFS率方面是有效的。结论：根据网络结局和SUCRA值，氯法拉滨联合阿糖胞苷（CR：79.05%，ORR：80.02%）和阿糖胞苷联合伏沙罗辛（CR：75.42%，ORR：73.43%）可能是CR和ORR的前两个选择。CPX-351（1年OS：91.36%）、HiDAC + MK-8776（3年OS：94.23%）和氯法拉滨+Ara-C（1年EFS：97.34%）分别产生了最高概率成为1年OS、3年OS和1年EFS的最佳选择。
Background/Aims: Acute myeloid leukemia (AML) is a relapsed and refractory hematological malignancy with a lower morbidity but higher mortality. In addition to hematopoietic stem cell transplantation, chemotherapy is used as the front-line treatment. However, the diversity of available agents and the inconsistency of outcomes of relevant trials render treatment decision-making tough. Network meta-analysis (NMA) is an efficient statistical framework that makes a comprehensive comparison and provides a valuable clinical reference. Methods: All the potential trials were retrieved from the medical database and screened according to the inclusion and exclusion criteria. The main characteristics of each trial as well as the primary outcomes, including complete remission (CR), overall response rate (ORR), overall survival (OS), and event-free survival (EFS), were extracted. In addition, the network graph was plotted to illustrate the connections among the trials involved. Comparison results in the network were exhibited in a forest plot. Furthermore, the surface under the cumulative ranking curve (SUCRA) was introduced to rank the treatments for each endpoint. Results: A total of 11 trials were selected from 1,625 identifications. No significant difference in the common treatment was observed for the endpoints CR and ORR. In terms of OS, CPX-351 (HR: 0.77, 95% CrI: 0.63, 0.94) and HiDAC plus MK-8776 (HR: 0.80, 95% CrI: 0.68, 0.93) showed a superiority over the common salvage regimen in the short term, while HiDAC plus MK-8776 (HR: 0.80, 95% CrI: 0.70, 0.93) and Ara-C plus vosaroxin (HR: 0.86, 95% CrI: 0.74, 0.99) outperformed the common salvage regimen for the 3-year OS. In addition, clofarabine plus Ara-C (HR: 0.61, 95% CrI: 0.53, 0.69) and CPX-351 (HR: 0.71, 95% CrI: 0.60, 0.83) were confirmed to be efficacious in enhancing the rate of EFS. Conclusion: Referring to the network outcome and SUCRA value, clofarabine plus Ara-C (CR: 79.05%, ORR: 80.02%) and Ara-C plus vosaroxin (CR: 75.42%, ORR: 73.43%) were potentially the top two choices for both CR and ORR. CPX-351 (1-year OS: 91.36%), HiDAC plus MK-8776 (3-year OS: 94.23%) and clofarabine plus Ara-C (1-year EFS: 97.34%) yielded the highest probabilities to be the optimal choices for 1-year OS, 3-year OS and 1-year EFS, respectively.
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DOI：
10.1007/978-3-030-73227-1_13
发表时间：
2021
期刊：
Practical Oncologic Molecular Pathology
影响因子：
--
作者：
Guang Yang;Linsheng Zhang
通讯作者：
Guang Yang;Linsheng Zhang
影响因子：
3.3
作者：
Sekine, Leo;Morais, Vinicius Daudt;Ribeiro, Rodrigo Antonini
通讯作者：
Ribeiro, Rodrigo Antonini
影响因子：
--
作者：
Long, Bing;Wang, Le-Xun;Liu, Quentin
通讯作者：
Liu, Quentin
影响因子：
6.5
作者：
Litzow MR;Othus M;Cripe LD;Gore SD;Lazarus HM;Lee SJ;Bennett JM;Paietta EM;Dewald GW;Rowe JM;Tallman MS;Eastern Cooperative Oncology Group Leukemia Committee
通讯作者：
Eastern Cooperative Oncology Group Leukemia Committee
影响因子：
45.3
作者：
Burnett, Alan K.;Russell, Nigel H.;Milligan, Donald
通讯作者：
Milligan, Donald