Bortezomib-based consolidation or maintenance therapy for multiple myeloma: a meta-analysis

Shijia Zhang; Amit A. Kulkarni; Beibei Xu; Haitao Chu; Taxiarchis Kourelis; Ronald S. Go; Michael L. Wang; Veronika Bachanova; Yucai Wang

doi:10.1038/s41408-020-0298-1

Bortezomib-based consolidation or maintenance therapy for multiple myeloma: a meta-analysis

Shijia Zhang, Amit A. Kulkarni, Beibei Xu, Haitao Chu, Taxiarchis Kourelis, Ronald S. Go, Michael L. Wang, Veronika Bachanova, Yucai Wang

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Abstract

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.

Original language	English (US)
Article number	33
Journal	Blood cancer journal
Volume	10
Issue number	3
DOIs	https://doi.org/10.1038/s41408-020-0298-1
State	Published - Mar 1 2020

Bibliographical note

Funding Information:
Dr. Michael Wang made the following disclosures: research grants, consulting/ advisory board, and honoraria—Janssen and Acerta Pharma; research grants and consulting/advisory board—Pharmacyclics, AstraZeneca, Celgene, Juno Therapeutics, Loxo Oncology, Kite Pharma, and BioInvent; research grants— BeiGene, VelosBio, and Aviara; consulting/advisory board—Pulse Biosciences and Guidepoint Global; consulting/advisory board and stock—MoreHealth; honoraria—OMI, Physicians Education Resources, and Oncology News, outside the submitted work. Dr. Veronika Bachanova reported non-financial support from ArticulateScience, grants from Novartis, grants from GT Biopharma, personal fees from Seattle Genetics, Kite Pharma, and Zymogen, outside the submitted work. No other disclosures were reported.

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© 2020, The Author(s).

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title = "Bortezomib-based consolidation or maintenance therapy for multiple myeloma: a meta-analysis",

abstract = "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.",

author = "Shijia Zhang and Kulkarni, {Amit A.} and Beibei Xu and Haitao Chu and Taxiarchis Kourelis and Go, {Ronald S.} and Wang, {Michael L.} and Veronika Bachanova and Yucai Wang",

note = "Funding Information: Dr. Michael Wang made the following disclosures: research grants, consulting/ advisory board, and honoraria—Janssen and Acerta Pharma; research grants and consulting/advisory board—Pharmacyclics, AstraZeneca, Celgene, Juno Therapeutics, Loxo Oncology, Kite Pharma, and BioInvent; research grants— BeiGene, VelosBio, and Aviara; consulting/advisory board—Pulse Biosciences and Guidepoint Global; consulting/advisory board and stock—MoreHealth; honoraria—OMI, Physicians Education Resources, and Oncology News, outside the submitted work. Dr. Veronika Bachanova reported non-financial support from ArticulateScience, grants from Novartis, grants from GT Biopharma, personal fees from Seattle Genetics, Kite Pharma, and Zymogen, outside the submitted work. No other disclosures were reported. Publisher Copyright: {\textcopyright} 2020, The Author(s).",

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Bortezomib-based consolidation or maintenance therapy for multiple myeloma: a meta-analysis

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