1. Efficacy and safety of bortezomib maintenance in patients with newly diagnosed multiple myeloma: a meta-analysis
- Author
-
Lu Zhang, Yu Hu, Jun-Ying Li, Chunyan Sun, Lei Chen, and Zhang-Bo Chu
- Subjects
0301 basic medicine ,Oncology ,Male ,medicine.medical_specialty ,maintenance therapy ,Biophysics ,Pharmacology ,Neutropenia ,Biochemistry ,Disease-Free Survival ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Maintenance therapy ,law ,Internal medicine ,medicine ,Humans ,Adverse effect ,Molecular Biology ,Multiple myeloma ,Research Articles ,Bortezomib ,business.industry ,Hazard ratio ,bortezomib ,Cell Biology ,medicine.disease ,Clinical trial ,Survival Rate ,meta-analysis ,multiple myeloma ,030104 developmental biology ,030220 oncology & carcinogenesis ,Female ,business ,medicine.drug ,Research Article - Abstract
Multiple myeloma (MM) is a B-cell neoplasm with a high incidence of relapse. Bortezomib has been extensively studied for the maintenance treatment of MM. Here, we carried out a meta-analysis to determine the efficacy and safety of maintenance therapy with bortezomib. We searched for clinical trials in PubMed (Medline), Embase (OVID), and the Cochrane Library. Two randomized controlled trials (RCTs) enrolling a total of 1338 patients were included. Bortezomib maintenance statistically significantly improved both progression-free survival (PFS) (hazard ratio (HR) 0.67, 95% confidence interval (CI) = 0.51 to 0.87, P=0.003) and overall survival (OS) (HR = 0.75 therapy, 95% CI = 0.63 to 0.89, P=0.001) more than did non-bortezomib maintenance therapy. Our analysis revealed higher incidence of neutropenia (risks ratios (RR) = 1.39; 95% CI = 1.08 to 1.79), peripheral neuropathy (PN) (RR = 2.23; 95% CI = 1.38 to 3.61, P=0.001), and cardiologic events (RR = 1.91; 95% CI = 1.12 to 3.28, P=0.02) in patients with bortezomib maintenance therapy. Our meta-analysis demonstrates OS and PFS benefits of bortezomib maintenance therapy in patients with newly diagnosed MM. However, the therapy is associated with increased risk of adverse events. Additionally, more RCTs are needed for better understanding and determination of optimal bortezomib maintenance therapy in MM.
- Published
- 2017