Efficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors: a meta-analysis

Abstract Background This study assessed the efficacy of proteasome inhibitors (PIs) in both maintenance and consolidation therapies for MM patients. Methods A comprehensive search across multiple databases was conducted, including PubMed, Science Direct, Google Scholar, CNKI, EMBASE, Web of Science,...

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Main Authors: Dan Wu, Feiqing Wang, Xu Yang, Bo Yang, Juan Chen, Jinyang Cheng, Bo Wei, Xiaoshuang Yuan, Tingting Tian, Zhenhua Liu, Zhixu He, Yang Liu, Yanju Li
Format: Article
Language:English
Published: Springer 2025-04-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-02304-w
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author Dan Wu
Feiqing Wang
Xu Yang
Bo Yang
Juan Chen
Jinyang Cheng
Bo Wei
Xiaoshuang Yuan
Tingting Tian
Zhenhua Liu
Zhixu He
Yang Liu
Yanju Li
author_facet Dan Wu
Feiqing Wang
Xu Yang
Bo Yang
Juan Chen
Jinyang Cheng
Bo Wei
Xiaoshuang Yuan
Tingting Tian
Zhenhua Liu
Zhixu He
Yang Liu
Yanju Li
author_sort Dan Wu
collection DOAJ
description Abstract Background This study assessed the efficacy of proteasome inhibitors (PIs) in both maintenance and consolidation therapies for MM patients. Methods A comprehensive search across multiple databases was conducted, including PubMed, Science Direct, Google Scholar, CNKI, EMBASE, Web of Science, MEDLINE, Cochrane Library, and others, to identify randomized controlled trials published in both Chinese and English languages that examined the use of PIs in either consolidation or maintenance therapy for multiple myeloma. The effectiveness outcomes assessed included complete response (CR), very good partial response or better (≥ VGPR), partial response (PR), progression-free survival (PFS), and overall survival (OS). Results Our analysis comprised four (4) randomized controlled trials investigating maintenance therapy and six (6) randomized controlled trials assessing consolidation therapy, including data from 4711 patients. PIS-based treatments significantly improved PFS and OS compared to the control group. PI-based consolidation therapy significantly prolonged PFS. In maintenance therapy, both PIs improved PFS and OS relative to the observation group. PIs significantly improved the achievements of CR in patients compared to the control group. CR attainment in maintenance therapy appeared slightly less effective than in consolidation therapy. PIs significantly improved ≥ VGPR in patients compared to the control group. Consolidation therapy demonstrated a greater improvement in ≥ VGPR compared to maintenance therapy. Conclusion Treatment with PI-based maintenance or consolidation therapy showed improvements in CR,  ≥ VGPR, PFS, and OS in patients with MM. However, it is noteworthy that PIs-based maintenance and consolidation therapy were associated with an increased risk of  ≥ grade 3 adverse events.
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spelling doaj-art-974df4bc27a14c8fb71e5bf6a608e2702025-08-20T02:28:04ZengSpringerDiscover Oncology2730-60112025-04-0116111510.1007/s12672-025-02304-wEfficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors: a meta-analysisDan Wu0Feiqing Wang1Xu Yang2Bo Yang3Juan Chen4Jinyang Cheng5Bo Wei6Xiaoshuang Yuan7Tingting Tian8Zhenhua Liu9Zhixu He10Yang Liu11Yanju Li12Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineDepartment of Hematology Oncology, Affiliated Hospital of Guizhou Medical UniversityClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineDepartment of Hepatobiliary Surgery, Guizhou Provincial People’s HospitalKey Laboratory of Adult Stem Cell Translational Research, Chinese Academy of Medical Sciences, Guizhou Medical UniversityClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineDepartment of Hematology Oncology, Affiliated Hospital of Guizhou Medical UniversityAbstract Background This study assessed the efficacy of proteasome inhibitors (PIs) in both maintenance and consolidation therapies for MM patients. Methods A comprehensive search across multiple databases was conducted, including PubMed, Science Direct, Google Scholar, CNKI, EMBASE, Web of Science, MEDLINE, Cochrane Library, and others, to identify randomized controlled trials published in both Chinese and English languages that examined the use of PIs in either consolidation or maintenance therapy for multiple myeloma. The effectiveness outcomes assessed included complete response (CR), very good partial response or better (≥ VGPR), partial response (PR), progression-free survival (PFS), and overall survival (OS). Results Our analysis comprised four (4) randomized controlled trials investigating maintenance therapy and six (6) randomized controlled trials assessing consolidation therapy, including data from 4711 patients. PIS-based treatments significantly improved PFS and OS compared to the control group. PI-based consolidation therapy significantly prolonged PFS. In maintenance therapy, both PIs improved PFS and OS relative to the observation group. PIs significantly improved the achievements of CR in patients compared to the control group. CR attainment in maintenance therapy appeared slightly less effective than in consolidation therapy. PIs significantly improved ≥ VGPR in patients compared to the control group. Consolidation therapy demonstrated a greater improvement in ≥ VGPR compared to maintenance therapy. Conclusion Treatment with PI-based maintenance or consolidation therapy showed improvements in CR,  ≥ VGPR, PFS, and OS in patients with MM. However, it is noteworthy that PIs-based maintenance and consolidation therapy were associated with an increased risk of  ≥ grade 3 adverse events.https://doi.org/10.1007/s12672-025-02304-wMultiple myelomaProteasome inhibitorsClinical cancer researchPrognostic factorRisk assessment
spellingShingle Dan Wu
Feiqing Wang
Xu Yang
Bo Yang
Juan Chen
Jinyang Cheng
Bo Wei
Xiaoshuang Yuan
Tingting Tian
Zhenhua Liu
Zhixu He
Yang Liu
Yanju Li
Efficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors: a meta-analysis
Discover Oncology
Multiple myeloma
Proteasome inhibitors
Clinical cancer research
Prognostic factor
Risk assessment
title Efficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors: a meta-analysis
title_full Efficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors: a meta-analysis
title_fullStr Efficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors: a meta-analysis
title_full_unstemmed Efficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors: a meta-analysis
title_short Efficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors: a meta-analysis
title_sort efficacy of maintenance or consolidation therapy for multiple myeloma based on proteasome inhibitors a meta analysis
topic Multiple myeloma
Proteasome inhibitors
Clinical cancer research
Prognostic factor
Risk assessment
url https://doi.org/10.1007/s12672-025-02304-w
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