Evidence map›Paper›PMID 34987165›Full record

SynthesisBlood cancer journal2022

Efficacy of front-line immunochemotherapy for follicular lymphoma: a network meta-analysis of randomized controlled trials.

Yucai Wang, Shouhao Zhou, Xinyue Qi, Fang Yang, Matthew J Maurer, Thomas M Habermann, Thomas E Witzig, Michael L Wang, Grzegorz S Nowakowski

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Blood cancer journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Yucai Wang *Division of Hematology, Mayo Clinic, Rochester, MN, USA. Wang.Yucai@mayo.edu.ORCID 0000-0002-1576-8341
Shouhao Zhou *Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
Xinyue QiDepartment of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Fang YangThe Comprehensive Cancer Centre of Drum Tower Hospital, Clinical Cancer Institute of Nanjing University, Nanjing, China.
Matthew J MaurerDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-1867-0526
Thomas M HabermannDivision of Hematology, Mayo Clinic, Rochester, MN, USA.
Thomas E WitzigDivision of Hematology, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-4215-6500
Michael L WangDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.ORCID 0000-0001-9748-5486
Grzegorz S NowakowskiDivision of Hematology, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-6955-9393
Mayo Clinic in Arizona · USThe University of Texas MD Anderson Cancer Center · USMayo Clinic in Florida · USNanjing Drum Tower Hospital · CNPennsylvania State University · US

Funding

The Role of Monocytes in non-Hodgkin LymphomaP50CA097274 · NCI · UNIVERSITY OF IOWA · PI WEINER, GEORGE J. · 2002 to 2021
$45.7M
6 · The paper itself

Abstract

Front-line treatment for follicular lymphoma has evolved with the introduction of maintenance therapy, bendamustine (Benda), obinutuzumab (G), and lenalidomide (Len). We conducted a random-effects Bayesian network meta-analysis (NMA) of phase 3 randomized controlled trials (RCTs) to identify the regimens with superior efficacy. Progression-free survival (PFS) was compared between 11 modern regimens with different immunochemotherapy and maintenance strategies. G-Benda-G resulted in with the best PFS, with an HR of 0.41 compared to R-Benda, a surface under the cumulative ranking curve (SUCRA) of 0.97, a probability of being the best treatment (PbBT) of 72%, and a posterior ranking distribution (PoRa) of 1 (95% BCI 1-3). This was followed by R-Benda-R4 (HR = 0.49, PbBT = 25%, PoRa = 2) and R-Benda-R (HR = 0.60, PbBT = 3%, PoRa = 3). R-CHOP-R (HR = 0.96) and R-Len-R (HR = 0.97) had similar efficacy to R-Benda. Bendamustine was a better chemotherapy backbone than CHOP either with maintenance (R-Benda-R vs R-CHOP-R, HR = 0.62; G-Benda-G vs G-CHOP-G, HR = 0.55) or without maintenance therapy (R-Benda vs R-CHOP, HR = 0.68). Rituximab maintenance improved PFS following R-CHOP (R-CHOP-R vs R-CHOP, HR = 0.65) or R-Benda (R-Benda-R vs R-Benda, HR = 0.60; R-Benda-R4 vs R-Benda, HR = 0.49). In the absence of multi-arm RCTs that include all common regimens, this NMA provides an important and useful guide to inform treatment decisions.

Indexed as

ImmunotherapyAntineoplastic Combined Chemotherapy ProtocolsBayes TheoremCyclophosphamideDoxorubicinHumansLymphoma, FollicularMaintenance ChemotherapyPrednisoneProgression-Free SurvivalRandomized Controlled Trials as TopicRituximabTreatment OutcomeVincristineCyclophosphamideDoxorubicinPrednisoneR-CHOP protocolRituximabVincristine

Identifiers

PMID34987165
PMCPMC8728708
OpenAlexW4206517464

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.