文章：

基于硼替佐米的巩固或维持治疗多发性骨髓瘤：一项荟萃分析

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

原文发布日期：2020-03-06

DOI: 10.1038/s41408-020-0298-1

类型: Article

开放获取: 是

英文摘要：

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.
 

摘要翻译： 

基于硼替佐米的治疗方案被广泛用作多发性骨髓瘤的诱导治疗。与来那度胺不同，硼替佐米在多发性骨髓瘤巩固和维持治疗中的作用尚不明确。我们进行了一项荟萃分析，旨在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。通过检索PubMed、Web of Science、Embase数据库及主要会议论文，收集将基于硼替佐米的方案作为多发性骨髓瘤巩固或维持治疗的随机对照试验。本研究共纳入10项随机对照试验，涉及3147例患者，将基于硼替佐米的方案与不含硼替佐米的方案或观察组进行对比。荟萃分析表明，基于硼替佐米的维持治疗可改善无进展生存期和总生存期。基于硼替佐米的巩固治疗可改善无进展生存期，但未能改善总生存期。基于硼替佐米的巩固/维持治疗会导致≥3级神经系统症状、胃肠道症状和疲劳的发生风险增加趋势。需要更多研究进一步评估基于硼替佐米的巩固和维持治疗在多发性骨髓瘤中的作用。

原文链接：

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