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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基于硼替佐米的多发性骨髓瘤巩固或维持治疗：一项荟萃分析。

基于硼替佐米的方案被广泛用作多发性骨髓瘤（MM）的诱导疗法。与来那度胺不同，硼替佐米在MM巩固和维持治疗中的作用尚不清楚。我们进行了荟萃分析，以评估基于硼替佐米的巩固和维持治疗对生存结局和不良事件的影响。搜索PubMed，Web of Science，Embase数据库和主要会议记录以寻找基于硼替佐米的方案作为MM巩固或维持疗法的随机对照试验（RCT）。荟萃分析包括10例RCT，纳入3147例患者。将基于硼替佐米的治疗方案与没有硼替佐米或未观察到的治疗方案进行比较。荟萃分析表明，基于硼替佐米的维持治疗改善了无进展生存期（PFS；危险比[HR] = 0.72，95％CI 0。55-0.95，P = 0.02）和总体生存率（OS； HR = 0.71，95％CI 0.58-0.87，P = 0.001）。基于硼替佐米的巩固治疗改善了PFS（HR = 0.77，95％CI 0.68-0.88，P <0.001），但未改善OS（HR = 0.98，95％CI 0.78-1.24，P = 0.87）。基于硼替佐米的巩固/维持疗法导致出现≥3级神经系统症状，胃肠道症状和疲劳风险增加的趋势。有必要进行更多的研究，以进一步评估基于硼替佐米的巩固和维持治疗对多发性骨髓瘤的作用。基于硼替佐米的巩固/维持疗法导致出现≥3级神经系统症状，胃肠道症状和疲劳风险增加的趋势。有必要进行更多的研究以进一步评估基于硼替佐米的巩固和维持治疗对多发性骨髓瘤的作用。基于硼替佐米的巩固/维持疗法导致出现≥3级神经系统症状，胃肠道症状和疲劳风险增加的趋势。有必要进行更多的研究以进一步评估基于硼替佐米的巩固和维持治疗对多发性骨髓瘤的作用。