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Bortezomib in Multiple Myeloma: Systematic Review and Clinical Considerations

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Juravinski Canc Ctr, Hamilton, ON, Canada
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Canc Care Ontario, Program Evidence Based Care, Hamilton, ON, Canada
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Sunnybrook Hlth Sci Ctr, Odette Canc Ctr, Toronto, ON, Canada
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Princess Margaret Hosp, Toronto, ON M4X 1K9, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2014, 21(4), 573-603; https://doi.org/10.3747/co.21.1798
Received: 6 May 2014 / Revised: 9 June 2014 / Accepted: 7 July 2014 / Published: 1 August 2014
We conducted a systematic review to determine the appropriate use of bortezomib alone or in combination with other agents in patients with multiple myeloma (MM). We searched MEDLINE, EMBASE, the Cochrane Library, conference proceedings, and the reference lists of included studies. We analyzed randomized controlled trials and systematic reviews if they involved adult MM patients treated with bortezomib and if they reported on survival, disease control, response, quality of life, or adverse effects. Twenty-six unique studies met the inclusion criteria. For patients with previously untreated MM and for candidates for transplantation, we found a statistically significant benefit in time to progression [hazard ratio (HR): 0.48, p < 0.001; and HR: 0.63, p = 0.006, respectively] and a better response with a bortezomib than with a non-bortezomib regimen (p < 0.001). Progression-free survival was longer with bortezomib and thalidomide than with thalidomide alone (p = 0.01). In non-candidates for transplantation, a significant benefit in overall survival was observed with a bortezomib regimen (HR compared with a non-bortezomib regimen: 0.61; p = 0.008), and in transplantation candidates receiving bortezomib, the response rate was improved after induction (p = 0.004) and after a first transplant (p = 0.016). In relapsed or refractory MM, overall survival (p = 0.03), time to progression (HR: 1.82; p = 0.000004), and progression-free survival (HR: 1.69; p = 0.000026) were significantly improved with bortezomib and pegylated liposomal doxorubicin (compared with bortezomib alone), and bortezomib monotherapy was better than dexamethasone alone (HR: 0.77; p = 0.027). Bortezomib combined with thalidomide and dexamethasone was better than either bortezomib monotherapy or thalidomide with dexamethasone (p < 0.001). In previously untreated or in relapsed or refractory MM patients, bortezomib-based therapy has
Keywords: bortezomib; multiple myeloma; proteasome inhibitors; systematic review bortezomib; multiple myeloma; proteasome inhibitors; systematic review
MDPI and ACS Style

Kouroukis, T.C.; Baldassarre, F.G.; Haynes, A.E.; Imrie, K.; Reece, D.E.; Cheung, M.C. Bortezomib in Multiple Myeloma: Systematic Review and Clinical Considerations. Curr. Oncol. 2014, 21, 573-603. https://doi.org/10.3747/co.21.1798

AMA Style

Kouroukis TC, Baldassarre FG, Haynes AE, Imrie K, Reece DE, Cheung MC. Bortezomib in Multiple Myeloma: Systematic Review and Clinical Considerations. Current Oncology. 2014; 21(4):573-603. https://doi.org/10.3747/co.21.1798

Chicago/Turabian Style

Kouroukis, T.C.; Baldassarre, F.G.; Haynes, A.E.; Imrie, K.; Reece, D.E.; Cheung, M.C. 2014. "Bortezomib in Multiple Myeloma: Systematic Review and Clinical Considerations" Curr. Oncol. 21, no. 4: 573-603. https://doi.org/10.3747/co.21.1798

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