Interferon as therapy for multiple myeloma: an individual patient data overview of 24 randomized trials and 4012 patients

Citation
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
Citations number
39
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology,"Cardiovascular & Hematology Research
Journal title
BRITISH JOURNAL OF HAEMATOLOGY
ISSN journal
0007-1048 → ACNP
Volume
113
Issue
4
Year of publication
2001
Pages
1020 - 1034
Database
ISI
SICI code
0007-1048(200106)113:4<1020:IATFMM>2.0.ZU;2-9
Abstract
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.