Monoclonal Antibodies versus Histone Deacetylase Inhibitors in Combination with Bortezomib or Lenalidomide plus Dexamethasone for the Treatment of Relapsed or Refractory Multiple Myeloma: An Indirect-Comparison Meta-Analysis of Randomized Controlled Trials

Table 4

Meta-analysis outcome of efficacy comparing monoclonal antibodies and HDACi.

	Number of trials included	Risk ratio (95% CI)			Tests for publication bias
		MAb group versus control group	HDACi group versus control group	MAb group versus HDACi group; (indirect comparison)	Egger’s test; ( value)	Begg’s test; ( value)
PFS	6 (trials 1, 2, 3, 4, 5, and 6)	HR 0.52 (0.36–0.75)	HR 0.70 (0.57–0.85)	HR 0.83 (0.66–0.98)	0.18	0.45
OS	4 (trials 3, 4, 5, and 6)	HR 0.75 (0.60–0.93)	HR 0.87 (0.72–1.05)	HR 0.87 (0.65–1.15)	0.39	0.73
CR	6 (trials 1, 2, 3, 4, 5, and 6)	1.42 (0.75–2.69)	1.71 (1.17–2.51)	0.85 (0.23–3.12)	0.17	0.02
VGPR	5 (trials 1, 2, 3, 4, and 5)	1.57 (1.23–2.00)	1.76 (1.32–2.33)	0.83 (0.44–1.57)	0.67	0.46
OR	6 (trials 1, 2, 3, 4, 5, and 6)	1.22 (1.16–1.29)	1.22 (1.10–1.34)	1.04(0.91–1.18)	0.89	1.00
PD + SD	6 (trials 1, 2, 3, 4, 5, and 6)	0.55 (0.38–0.78)	0.73 (0.62–0.87)	0.80 (0.65–0.94)	0.32	0.26

MAb: monoclonal antibody; HDACi: histone deacetylase inhibitor; PFS: progression-free survival; OS: overall survival; OR: overall response; CR: complete response; VGPR: very good partial response; PR: partial response; SD: stable disease; PD: progressive disease; HR: hazard ratio. Trials included: trial 1 represents Palumbo et al. (2016); trial 2 represents Dimopoulos et al. (2016); trial 3 represents Lonial et al. (2015); trial 4 represents Jakubowiak et al. (2016); trial 5 represents San-Miguel et al. (2014); trial 6 represents Dimopoulos et al. (2013).