P. Casassus et al., Interferon as therapy for multiple myeloma: an individual patient data overview of 24 randomized trials and 4012 patients, BR J HAEM, 113(4), 2001, pp. 1020-1034
Many randomized trials have evaluated alpha -interferon as myeloma therapy,
some suggesting a benefit and others not. Most were too small to give reli
able answers, so a systematic overview has been performed to provide a more
reliable estimate of the effect of interferon. The main end-points were re
sponse rates (induction trials), progression-free survival (PFS) and overal
l survival (OS). Individual patient data were supplied for 24 trials involv
ing 4012 patients, 12 induction trials (2469 patients) and 12 maintenance t
rials (1543 patients). In induction, response rates were slightly better wi
th interferon (57.5% versus 53.1%, P = 0.01). PFS was better with interfero
n (33% versus 24% at 3 years, P < 0.00001), an effect seen in both inductio
n (P = 0.0003) and maintenance (P < 0.00001) trials. Median time to progres
sion was increased by about 6 months in both settings, OS was somewhat bett
er with interferon (53% versus 49% at 3 years, P = 0.01) with median surviv
al increased by about 4 months, This benefit was restricted to the smaller
trials. The effect of interferon was not significantly related to the dose
or duration of interferon or to patients' characteristics. PFS was improved
with interferon, but the survival benefit, if any, was small and needs bal
ancing against cost and toxicity.