TY - JOUR
T1 - Bortezomib-based consolidation or maintenance therapy for multiple myeloma
T2 - a meta-analysis
AU - Zhang, Shijia
AU - Kulkarni, Amit A.
AU - Xu, Beibei
AU - Chu, Haitao
AU - Kourelis, Taxiarchis
AU - Go, Ronald S.
AU - Wang, Michael L.
AU - Bachanova, Veronika
AU - Wang, Yucai
N1 - Publisher Copyright:
© 2020, The Author(s).
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Bortezomib-based regimens are widely used as induction therapy for multiple myeloma (MM). Unlike lenalidomide, the role of bortezomib in consolidation and maintenance therapy for MM is less clear. We performed a meta-analysis to evaluate the impact of bortezomib-based consolidation and maintenance therapy on survival outcomes and adverse events. PubMed, Web of Science, Embase databases, and major conference proceedings were searched for randomized controlled trials (RCTs) of bortezomib-based regimens as consolidation or maintenance therapy for MM. Ten RCTs enrolling 3147 patients were included in the meta-analysis. Bortezomib-based regimens were compared with regimens without bortezomib or observation. The meta-analysis suggested that bortezomib-based maintenance therapy improved progression-free survival (PFS; hazard ratio [HR] = 0.72, 95% CI 0.55–0.95, P = 0.02) and overall survival (OS; HR = 0.71, 95% CI 0.58–0.87, P = 0.001). Bortezomib-based consolidation therapy improved PFS (HR = 0.77, 95% CI 0.68–0.88, P < 0.001) but not OS (HR = 0.98, 95% CI 0.78–1.24, P = 0.87). Bortezomib-based consolidation/maintenance therapy led to a trend toward increased risk of grade ≥ 3 neurologic symptoms, gastrointestinal symptoms, and fatigue. More research is warranted to further assess the role of bortezomib-based consolidation and maintenance therapy for multiple myeloma.
AB - Bortezomib-based regimens are widely used as induction therapy for multiple myeloma (MM). Unlike lenalidomide, the role of bortezomib in consolidation and maintenance therapy for MM is less clear. We performed a meta-analysis to evaluate the impact of bortezomib-based consolidation and maintenance therapy on survival outcomes and adverse events. PubMed, Web of Science, Embase databases, and major conference proceedings were searched for randomized controlled trials (RCTs) of bortezomib-based regimens as consolidation or maintenance therapy for MM. Ten RCTs enrolling 3147 patients were included in the meta-analysis. Bortezomib-based regimens were compared with regimens without bortezomib or observation. The meta-analysis suggested that bortezomib-based maintenance therapy improved progression-free survival (PFS; hazard ratio [HR] = 0.72, 95% CI 0.55–0.95, P = 0.02) and overall survival (OS; HR = 0.71, 95% CI 0.58–0.87, P = 0.001). Bortezomib-based consolidation therapy improved PFS (HR = 0.77, 95% CI 0.68–0.88, P < 0.001) but not OS (HR = 0.98, 95% CI 0.78–1.24, P = 0.87). Bortezomib-based consolidation/maintenance therapy led to a trend toward increased risk of grade ≥ 3 neurologic symptoms, gastrointestinal symptoms, and fatigue. More research is warranted to further assess the role of bortezomib-based consolidation and maintenance therapy for multiple myeloma.
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U2 - 10.1038/s41408-020-0298-1
DO - 10.1038/s41408-020-0298-1
M3 - Article
C2 - 32144237
AN - SCOPUS:85081529633
SN - 2044-5385
VL - 10
JO - Blood cancer journal
JF - Blood cancer journal
IS - 3
M1 - 33
ER -