Efficacy and safety of Venetoclax-based regimens in relapsed or refractory multiple myeloma: a systematic review and meta-analysis of prospective clinical trials

Ann Med. 2023 Dec;55(1):1029-1036. doi: 10.1080/07853890.2023.2186480.

Abstract

Background: Multiple myeloma (MM) is an incurable malignancy. Venetoclax (VEN) shows a meaningful effect in MM patients who are relapsed or refractory (RR) to previous standard therapies.

Objective: This study aimed to assess the efficacy and safety of VEN-based treatments in RR MM patients.

Materials and methods: Comprehensive studies were searched in PubMed, Embase, Web of Science and Cochrane library. Efficacy was assessed by overall response rate (ORR), strict complete response rate (sCR), complete response rate (CR), very good partial response rate (VGPR) and partial response rate (PR).

Results: Seven studies containing 482 subjests were included. The pooled ORR, ≥ CR (sCR + CR), VGPR and PR were 68% (51%-85%), 24% (13%-35%), 25% (17%-34%) and 17% (11%-24%) respectively. Multi-drug treatments were superior to VEN ± dexamethasone (Dex) treatments in ORR (82% vs 42%, p = .003) and ≥ CR (36% vs 7%, p < 0.00001). Subgroup analysis indicated patients achieve higher ORR who harboring t(11;14) translocation or containing high BCL-2 expression.

Conclusions: VEN-containing regimens could be suggested as effective and safe treatments to RR MM patients with t(11;14) or high BCL-2 levels.

Keywords: BCL-2 expression; BCL-2 inhibitor; adverse event; regimen; t(4;14).

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bridged Bicyclo Compounds, Heterocyclic / adverse effects
  • Humans
  • Multiple Myeloma*
  • Prospective Studies

Substances

  • venetoclax
  • Bridged Bicyclo Compounds, Heterocyclic

Grants and funding

The present study was supported by Funds of the Science and Technology Project of Jinhua (no. 2018-3-006).