CLO20-061: A Meta-Analysis on the Safety of Panobinostat Compared to Eltozumab and Ixazomib for the Treatment of Multiple Myeloma

Background: The role of panobinostat compared to elotuzumab and ixazomib in patients with multiple myeloma(MM) continues to be debated in the context of its complications. Methods: MedLine and Cochrane databases were queried with different MeSH terms and articles relevant to MM were identified. Data was analyzed on a fixed-effect model to calculate an unadjusted odds ratio (OR) using RevMan 5.3 Results: A total of 4 articles comprising of 891 patients compared the grade 3 and 4 complications between Panabinostat and Eltozumab. Panobinostat was associated with a 10% lower risk, but not significantly different rate of complications compared to Elozumab (OR 0.90, 95% CI 0.69-1.19, p=0.47). In a subgroup of 2 studies (203 patients) a significantly lower risk (45%) of complications rate was seen with Panobinostat in comparison to Ixazomib (OR 0.55, 95% CI 0.31-0.96, p=0.04). Overall Panobinostat had an 18% lower risk of complications against all other drugs (OR 0.82, 95% CI 0.64-10.5, p=0.11) Figure 1. Paobinostat had a significantly lower risk of lymphopenia (OR 0.25 95% CI 0.15-0.42, p=<0.0001) Panobinostat was however, associated with two times more risk of anemia (OR 2.82 95% CI 1.82-4.38, p=<0.0001), fatigue (OR 2.36 95% CI 1.64-3.38, p=<0.0001), diarrhea (OR 2.89 95% CI 2.21-3.38, p=<0.0001). Panobinostat in a head to head comparison with Elotuzumab in seven studies showed a significantly higher risk of thrombocytopenia (OR 6.53 95% CI 4.61-9.24 p=<0.0001). Conclusion: Panobinostat is associated with a substantially higher odds of anemia, thrombocytopenia, fatigue and diarrhea. However, it has a 75% lower risk of neutropenia and 10% lower risk of grade 3 and 4 complications.

Figure 1
Figure 1

Odds ratio of grade 3 and grade 4 complications between Panobinostat and other MM medications

Citation: Journal of the National Comprehensive Cancer Network J Natl Compr Canc Netw 18, 3.5; 10.6004/jnccn.2019.7469

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Corresponding Author: Nishanth Thalambedu, MD
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    Odds ratio of grade 3 and grade 4 complications between Panobinostat and other MM medications

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