{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T05:12:17Z","timestamp":1768972337520,"version":"3.49.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T00:00:00Z","timestamp":1537401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Autologous transplantation continues to be the cornerstone of younger and fit multiple myeloma patients. It is known that frontline induction therapy before transplantation can influence post\u2010transplant results. Therefore, best frontline treatment for transplant\u2010eligible patients should be based on best available evidence to guide therapy. Furthermore, until now due to data scarcity, it was not possible to thoroughly compare lenalidomide to other regimens in this setting. We performed a systematic review and network (mixed treatment comparison) meta\u2010analysis of 21 clinical trial publications, enrolling 6474 patients and comparing 11 different treatment frontline setting regimens regarding survival, response, and safety outcomes. OS analysis showed superiority of CRD (cyclophosphamide\u2010lenalidomide\u2010dexamethasone) over TD\u2010based (thalidomide\u2010dexamethasone, HR\u00a0=\u00a00.76,0.62\u20100.90), VAD\u2010based (HR\u00a0=\u00a00.71,0.52\u20100.90), and Z\u2010Dex (idarubicin\u2010dexamethasone, HR\u00a0=\u00a00.37,0.17\u20100.76) regimens. Concerning PFS, VTD (bortezomib\u2010thalidomide\u2010dexametasone) showed superior results when compared with TD\u2010based (HR\u00a0=\u00a00.66,0.51\u20100.84), VAD\u2010based (HR\u00a0=\u00a00.61,0.46\u20100.82), Z\u2010Dex (HR\u00a0=\u00a00.42,0.22\u20100.78), and high dose dexamethasone (Dex, HR\u00a0=\u00a00.62,0.41\u20100.90) regimens. Bortezomib\/thalidomide regimens were not superior to lenalidomide, considering these outcomes. Also, concerning complete and overall response, VTD ranked first among other regimens, showing clear superiority over thalidomide\u2010only containing protocols. Safety outcome evaluated infectious, cardiac, gastrointestinal, neurological, thrombotic, and hematological grade 3 to 4 adverse events. Risk of thrombotic events was higher with TAD (thalidomide\u2010doxorubicin\u2010dexamethasone), neurological with PAD (bortezomib\u2010doxorubicin\u2010dexamethasone), infectious with Dex, hematological with Z\u2010Dex, gastrointestinal with VTD, and cardiac with PAD regimens. Our study endorses current recommendations on combined immunomodulatory drugs and proteasome inhibitors frontline regimens (in triplets) in transplant\u2010eligible multiple myeloma patients, but also formally demonstrates the favorable performance of lenalidomide in overall and progression\u2010free survival, when compared with bortezomib\/thalidomide protocols.<\/jats:p>","DOI":"10.1002\/hon.2552","type":"journal-article","created":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T15:19:30Z","timestamp":1534951170000},"page":"62-74","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Frontline treatment for transplant\u2010eligible multiple myeloma: A 6474 patients network meta\u2010analysis"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7140-4980","authenticated-orcid":false,"given":"Leo","family":"Sekine","sequence":"first","affiliation":[{"name":"Post\u2010graduation Program in Epidemiology\u2014Universidade Federal do Rio Grande do Sul  Porto Alegre Brazil"},{"name":"Hospital de Cl\u00ednicas de Porto Alegre  Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patr\u00edcia Klarmann","family":"Ziegelmann","sequence":"additional","affiliation":[{"name":"Post\u2010graduation Program in Epidemiology\u2014Universidade Federal do Rio Grande do Sul  Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Manica","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre  Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"da Fonte Pithan","sequence":"additional","affiliation":[{"name":"Hospital Materno\u2010Infantil Presidente Vargas  Porto Alegre 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Federal de Ci\u00eancias M\u00e9dicas de Porto Alegre  Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo Antonini","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Post\u2010graduation Program in Epidemiology\u2014Universidade Federal do Rio Grande do Sul  Porto Alegre 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