Drug Design, Development and Therapy (May 2019)
Subcutaneous bortezomib might be standard of care for patients with multiple myeloma: a systematic review and meta-analysis
Abstract
Ziqi Ye,1,* Jie Chen,2,* Zixue Xuan,3 Wenchao Yang,4 Jing Chen51Department of Pharmacy, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 2Department of Pharmacy, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 3Department of Pharmacy, Zhejiang Provincial People’s Hospital, Hangzhou, People’s Republic of China; 4Department of Pharmacy, Traditional Chinese Medical Hospital of Zhuji, Zhuji, People’s Republic of China; 5Department of Medical Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China*These authors contributed equally to this workBackground: Administration of subcutaneous (SC) bortezomib in patients with multiple myeloma (MM) has increased in recent years. Yet, it is unclear whether there is sufficient evidence to support the use of SC bortezomib as a standard of care.Methods: A systematic review of 4 randomized controlled trials and 8 retrospective trials comparing SC to intravenous (IV) bortezomib among 1,857 MM patients was performed. Embase, PubMed, Clinical Trials.gov, Cochrane Library and reference lists were searched for relevant studies from inception until August 2018. Outcomes of interest included 1-year overall survival (OS), 1-year progression-free survival (PFS), objective response rate (ORR) and adverse events (AEs). Random events meta-analyses were performed. We also performed sensitivity analysis to examine whether the results of the meta-analysis were robust.Results: Compared to IV administration, SC bortezomib had a significantly lower incidence of some all-grade or grade 3–4 AE, such as peripheral sensory neuropathy, leukopenia and thrombocytopenia (p<0.05). There was no statistical difference in 1-year OS, 1-year PFS, ORR between SC and IV bortezomib (p>0.05).Conclusion: The data presented so far consistently show that SC bortezomib has become a standard of care for patients with MM.Keywords: subcutaneous bortezomib, intravenous bortezomib, multiple myeloma, efficacy, adverse events, systematic review
