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

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.

Automated summary

This study assessed the efficacy and safety of VEN-based treatments in relapsed or refractory multiple myeloma patients. The results showed that VEN treatment achieved meaningful responses in terms of ORR, CR, VGPR, and PR. Furthermore, multi-drug treatments were more effective than VEN +/- Dex treatments, and patients with t(11;14) translocation or high BCL-2 expression showed better response to VEN treatment.