Efficacy and Safety of Bortezomib Combined with the Chemotherapeutic Regimen in the Treatment of Mantle Cell Lymphoma and Follicular Lymphoma: A Meta-analysis

Abstract

Objective: To systematically evaluate the efficacy and safety of bortezomib with chemotherapy in the treatment of mantle-cell lymphoma and follicular lymphoma. Methods: Randomized controlled clinical trials are conducted. Odd ratios and 95% confidence intervals were applied to pool the effect size. Results: This study identified 3 eligible studies, including 1179 patients with mantle-cell lymphoma or follicular lymphoma. Bortezomib-based chemotherapy treatment was presented to increase the proportion of complete response (OR=1.56, 95%CI=1.20-2.02) in a fixed-effect model, with no heterogeneity among the three studies (I2=0.0%, P=0.883). Odd ratios of overall response (OR=1.61, 95%CI=0.81-3.20) had no statistically significant difference; however, the heterogeneity was significant among the three studies (I2=64.5%, P=0.060). The risk of any adverse events (grade≥3) and peripheral neuropathy (all grades) were estimated by Odd ratios. There was an increasing risk of any adverse events (grade≥3) in the group with bortezomib (OR=3.15, 95%CI=2.26-4.40), with no heterogeneity (I2=0.0%, P=0.594). No significant difference was founded to estimate the risk of peripheral neuropathy (all grades) (OR=4.14, 95%CI=0.43-40.23), and we examined a considerable heterogeneity (I2=92.2%, P=0.000). Conclusion: The chemotherapy protocol with bortezomib is superior to the protocol without bortezomib according to CR. The regimen with bortezomib increases the incidence of any adverse effects (grade≥3) with no statistical difference of peripheral neuropathy (all grades).