Thalidomide maintenance therapy for patients with multiple myeloma: Meta-analysis

We performed a meta-analysis of randomized controlled trials comparing thalidomide maintenance with other regimens after induction chemotherapy for multiple myeloma. Overall, 6 trials including 2786 patients were identified. Patients treated with thalidomide maintenance had marginally better overall survival (hazard ratio HR 0.83, P = 0.07). The improvement was especially prominent in a subgroup of studies using corticosteroids with thalidomide (HR 0.70, P = 0.02). Thalidomide improved progression-free survival (HR 0.65, P < 0.01), but had more frequent venous thrombosis (risk difference 0.024, P < 0.05) and peripheral neuropathy (risk difference 0.072, P < 0.01). These results suggest that thalidomide maintenance with corticosteroids is effective in prolonging survival for multiple myeloma.