According to the results of a recent systematic review and meta-analysis, subcutaneous (SC) administration of bortezomib can be regarded as a standard of care in the treatment of multiple myeloma (MM).
Today, about 154,000 active cases and 101,000 deaths are owing to MM throughout the world every year. Bortezomib, an emerging first-in-class proteasome inhibitor is a first of its type approved by the FDA to treat multiple myeloma, both newly diagnosed and relapsed MM. This agent is available for both intravenous (IV) injection and subcutaneous use. However, adverse effects like peripheral neuropathy are still common regardless bortezomib is wide use and concerns are still there regarding optimal regimen and administration route.
This research has been undertaken to evaluate whether SC route of administration is the standard of care in MM treatment or not. In search of relevant studies, clinical trial.gov, PubMed, Cochrane Library, Embase and reference lists were explored and 8 retrospective trials and 4 randomized controlled trials comparing modes of administration (SC and IV) were included. Afterwards, meta-analysis and sensitivity analysis were performed.
During the research, no statistical difference was noticed among modes of administration regarding 1-year progression-free survival (PFS), objective response rate (ORR) and 1-year overall survival (OS). However, the incidence of all grade and grade 3-4 adverse events, for instance, leukopenia, peripheral sensory neuropathy, and thrombocytopenia were lower with SC bortezomib. Based on these outcomes, SC mode of delivering bortezomib has found be as a standard of care for MM patients.