title: Arsenic trioxide-based therapy in relapsed/refractory multiple myeloma patients: a meta-analysis and systematic review.
abstract: Multiple myeloma (MM) is a clonal malignancy characterized by the proliferation of malignant plasma cells in the bone marrow and the production of monoclonal immunoglobulin. Although some newly approved drugs (thalidomide, lenalidomide, and bortezomib) demonstrate significant benefit for MM patients with improved survival, all MM patients still relapse. Arsenic trioxide (ATO) is the most active single agent in acute promyelocytic leukemia, the antitumor activity of which is partly dependent on the production of reactive oxygen species. Due to its multifaceted effects observed on MM cell lines and primary myeloma cells, Phase I/II trials have been conducted in heavily pretreated patients with relapsed or refractory MM. Therapy regimens varied dramatically as to the dosage of ATO and monotherapy versus combination therapy with other agents available for the treatment of MM. Although ATO-based combination treatment was well tolerated by most patients, most trials found that ATO has limited effects on MM patients. However, since small numbers of patients were randomized to different treatment arms, trials have not been statistically powered to determine the differences in progression-free survival and overall survival among the experimental arms. Therefore, large Phase III studies of ATO-based randomized controlled trials will be needed to establish whether ATO has any potential beneficial effects in the clinical setting.
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Xuepeng
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Bing
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Guo
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Jinxing
authors.initials: J
authors.lastname: Lou
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Area of PLA, Beijing, People's Republic of China.
authors.forename: Huiren
authors.initials: H
authors.lastname: Chen
keywords: arsenic trioxide; clinical trial; meta-analysis; multiple myeloma; therapy