Clinical benefits and safety of FMS-like tyrosine kinase 3 inhibitors in various treatment stages of acute myeloid leukemia: a systematic review, meta-analysis, and network meta-analysis
Background: Given the controversial roles of FMS-like tyrosine kinase 3 inhibitors (FLT3i) in various treatment stages of acute myeloid leukemia (AML), this study was designed to assess this problem and further explored which FLT3i worked more effectively. Methods: A systematic review, meta-analysis...
Gespeichert in:
| Hauptverfasser: | , , |
|---|---|
| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
03 June 2021
|
| In: |
Frontiers in oncology
Year: 2021, Jahrgang: 11, Pages: 1-13 |
| ISSN: | 2234-943X |
| DOI: | 10.3389/fonc.2021.686013 |
| Online-Zugang: | Resolving-System, kostenfrei, Volltext: https://doi.org/10.3389/fonc.2021.686013 Verlag, kostenfrei, Volltext: https://www.frontiersin.org/articles/10.3389/fonc.2021.686013 
|
| Verfasserangaben: | Qingyu Xu, Shujiao He and Li Yu |
MARC
| LEADER | 00000caa a2200000 c 4500 | ||
|---|---|---|---|
| 001 | 1847203418 | ||
| 003 | DE-627 | ||
| 005 | 20240325154033.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 230602s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3389/fonc.2021.686013 |2 doi | |
| 035 | |a (DE-627)1847203418 | ||
| 035 | |a (DE-599)KXP1847203418 | ||
| 035 | |a (OCoLC)1389536474 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rda | ||
| 041 | |a eng | ||
| 084 | |a 33 |2 sdnb | ||
| 100 | 1 | |a Xu, Qingyu |d 1992- |e VerfasserIn |0 (DE-588)1257157019 |0 (DE-627)1801237581 |4 aut | |
| 245 | 1 | 0 | |a Clinical benefits and safety of FMS-like tyrosine kinase 3 inhibitors in various treatment stages of acute myeloid leukemia |b a systematic review, meta-analysis, and network meta-analysis |c Qingyu Xu, Shujiao He and Li Yu |
| 264 | 1 | |c 03 June 2021 | |
| 300 | |a 13 | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Gesehen am 02.06.2023 | ||
| 520 | |a Background: Given the controversial roles of FMS-like tyrosine kinase 3 inhibitors (FLT3i) in various treatment stages of acute myeloid leukemia (AML), this study was designed to assess this problem and further explored which FLT3i worked more effectively. Methods: A systematic review, meta-analysis and network meta-analysis (NMA) were conducted by filtering PubMed, Embase, Cochrane library, and Chinese databases. We included studies comparing therapeutic effects between FLT3i and non-FLT3i group in AML, particularly FLT3(+) patients, or demonstrating the efficiency of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in FLT3(+) AML. Relative risk (RR) with 95% confidence intervals (CI) was used for estimating complete remission (CR), early death and toxicity. Hazard ratio (HR) was used to assess overall survival (OS), event-free survival (EFS), relapse-free survival (RFS) and cumulative incidence of relapse (CIR). Results: After addressing all criteria, 39 studies were eventually analyzed. Better CR was accomplished by FLT3i in untreated AML (RR 0.88, p = 0.04) and refractory and relapsed FLT3(+) AML (rrAML) (RR 0.61, p < 0.01) compared to non-FLT3i arm, followed by improved survival (untreated AML: OS, HR 0.76; EFS, HR 0.67; RFS, HR 0.72; all p < 0.01; FLT3(+) rrAML: OS, HR 0.60, p < 0.01; RFS, HR 0.40, p = 0.01). In addition, allo-HSCT improved survival in FLT3(+) AML (OS, HR 0.53; EFS, HR 0.50; RFS, HR 0.57; CIR, HR 0.26; all p < 0.01), which was further prolonged by FLT3i administrated after allo-HSCT (OS, HR 0.45; RFS, HR 0.34; CIR, HR 0.32; all p < 0.01). Additionally, FLT3i consistently improved OS (p < 0.05) regardless of FLT3-ITD ratio, when compared to non-FLT3i group. Besides, FLT3i showed significantly increased risk of thrombocytopenia, neutropenia, anemia, skin- and cardiac-related adverse effects, increased alanine aminotransferase, and increased risk of cough and dyspnea (p < 0.05). In NMA, gilteritinib showed the highest probability for improved prognosis. Conclusions: FLT3i safely improved prognosis in induction/reinduction stage of FLT3(+) AML and further boosted survival benefits from allo-HSCT as maintenance therapy, suggesting better prognosis if FLT3i is combined before and after allo-HSCT. In NMA, gilteritinib potentially achieved the best prognosis, which should be identified in direct trials. | ||
| 700 | 1 | |a He, Shujiao |e VerfasserIn |0 (DE-588)1291599657 |0 (DE-627)1847205011 |4 aut | |
| 700 | 1 | |a Yu, Li |e VerfasserIn |0 (DE-588)129161172X |0 (DE-627)1847210279 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Frontiers in oncology |d Lausanne : Frontiers Media, 2011 |g 11(2021) vom: Juni, Artikel-ID 686013, Seite 1-13 |h Online-Ressource |w (DE-627)684965518 |w (DE-600)2649216-7 |w (DE-576)35841184X |x 2234-943X |7 nnas |a Clinical benefits and safety of FMS-like tyrosine kinase 3 inhibitors in various treatment stages of acute myeloid leukemia a systematic review, meta-analysis, and network meta-analysis |
| 773 | 1 | 8 | |g volume:11 |g year:2021 |g month:06 |g elocationid:686013 |g pages:1-13 |g extent:13 |a Clinical benefits and safety of FMS-like tyrosine kinase 3 inhibitors in various treatment stages of acute myeloid leukemia a systematic review, meta-analysis, and network meta-analysis |
| 856 | 4 | 0 | |u https://doi.org/10.3389/fonc.2021.686013 |x Resolving-System |x Verlag |z kostenfrei |3 Volltext |
| 856 | 4 | 0 | |u https://www.frontiersin.org/articles/10.3389/fonc.2021.686013 |x Verlag |z kostenfrei |3 Volltext |
| 951 | |a AR | ||
| 992 | |a 20230602 | ||
| 993 | |a Article | ||
| 994 | |a 2021 | ||
| 998 | |g 1257157019 |a Xu, Qingyu |m 1257157019:Xu, Qingyu |d 60000 |d 61200 |e 60000PX1257157019 |e 61200PX1257157019 |k 0/60000/ |k 1/60000/61200/ |p 1 |x j | ||
| 999 | |a KXP-PPN1847203418 |e 4328715852 | ||
| BIB | |a Y | ||
| SER | |a journal | ||
| JSO | |a {"physDesc":[{"extent":"13 S."}],"relHost":[{"title":[{"title":"Frontiers in oncology","title_sort":"Frontiers in oncology"}],"part":{"year":"2021","pages":"1-13","text":"11(2021) vom: Juni, Artikel-ID 686013, Seite 1-13","volume":"11","extent":"13"},"pubHistory":["2011 -"],"recId":"684965518","language":["eng"],"note":["Gesehen am 07.11.13"],"disp":"Clinical benefits and safety of FMS-like tyrosine kinase 3 inhibitors in various treatment stages of acute myeloid leukemia a systematic review, meta-analysis, and network meta-analysisFrontiers in oncology","type":{"bibl":"periodical","media":"Online-Ressource"},"id":{"issn":["2234-943X"],"zdb":["2649216-7"],"eki":["684965518"]},"origin":[{"dateIssuedKey":"2011","publisher":"Frontiers Media","dateIssuedDisp":"2011-","publisherPlace":"Lausanne"}],"physDesc":[{"extent":"Online-Ressource"}]}],"name":{"displayForm":["Qingyu Xu, Shujiao He and Li Yu"]},"origin":[{"dateIssuedKey":"2021","dateIssuedDisp":"03 June 2021"}],"id":{"eki":["1847203418"],"doi":["10.3389/fonc.2021.686013"]},"type":{"bibl":"article-journal","media":"Online-Ressource"},"note":["Gesehen am 02.06.2023"],"language":["eng"],"recId":"1847203418","person":[{"family":"Xu","given":"Qingyu","display":"Xu, Qingyu","roleDisplay":"VerfasserIn","role":"aut"},{"role":"aut","display":"He, Shujiao","roleDisplay":"VerfasserIn","given":"Shujiao","family":"He"},{"role":"aut","roleDisplay":"VerfasserIn","display":"Yu, Li","given":"Li","family":"Yu"}],"title":[{"title_sort":"Clinical benefits and safety of FMS-like tyrosine kinase 3 inhibitors in various treatment stages of acute myeloid leukemia","title":"Clinical benefits and safety of FMS-like tyrosine kinase 3 inhibitors in various treatment stages of acute myeloid leukemia","subtitle":"a systematic review, meta-analysis, and network meta-analysis"}]} | ||
| SRT | |a XUQINGYUHECLINICALBE0320 | ||