Unlike lenalidomide, the role of bortezomib in the consolidation or maintenance setting is less clear. Bortezomib has been used off label for consolidation or maintenance therapy after the initial treatment of MM, particularly for those with high-risk disease 10. Bortezomib-based regimens are widely used as induction therapy for MM 7, 8, 9. Bortezomib is a first-in-class proteasome inhibitor that can lead to cell-cycle arrest and apoptosis 6. Although generally well-tolerated, lenalidomide is associated with increased risk for neutropenia, thrombocytopenia, anemia, infections, thromboembolism, and second primary cancers 4, 5. Maintenance therapy aims to extend the period of disease quiescence with a longer course of a less-intensive regimen 3.Īt the time of analysis, lenalidomide was the only Food and Drug Administration (FDA)-approved drug in the United States (US) for maintenance therapy after ASCT in MM. Consolidation therapy is a short course of treatment to deepen the response to the initial therapy. Therefore, a large portion of patients are given consolidation or maintenance therapy with the intent to prolong progression-free survival (PFS) and overall survival (OS). Despite therapeutic advancements and the availability of novel drugs, disease relapse is inevitable for the majority of patients after the initial treatment. For transplant-ineligible patients, triplet or doublet drug combinations are typically recommended for induction therapy 2. The initial treatment of newly diagnosed MM patients who are transplant-eligible is induction chemotherapy with a triple-drug regimen followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT). Better understanding of the disease’s pathophysiology has led to recent advances in therapy and improved patient outcomes dramatically. It is the second most common hematologic malignancy, accounting for about 1% of all cancers 1. Multiple myeloma (MM) is a clonal plasma cell neoplasm that is associated with significant morbidity and mortality. More research is warranted to further assess the role of bortezomib-based consolidation and maintenance therapy for multiple myeloma. Bortezomib-based consolidation/maintenance therapy led to a trend toward increased risk of grade ≥ 3 neurologic symptoms, gastrointestinal symptoms, and fatigue. The meta-analysis suggested that bortezomib-based maintenance therapy improved progression-free survival (PFS hazard ratio = 0.72, 95% CI 0.55–0.95, P = 0.02) and overall survival (OS HR = 0.71, 95% CI 0.58–0.87, P = 0.001). Bortezomib-based regimens were compared with regimens without bortezomib or observation. Ten RCTs enrolling 3147 patients were included in the meta-analysis. PubMed, Web of Science, Embase databases, and major conference proceedings were searched for randomized controlled trials (RCTs) of bortezomib-based regimens as consolidation or maintenance therapy for MM. We performed a meta-analysis to evaluate the impact of bortezomib-based consolidation and maintenance therapy on survival outcomes and adverse events. Unlike lenalidomide, the role of bortezomib in consolidation and maintenance therapy for MM is less clear. Bortezomib-based regimens are widely used as induction therapy for multiple myeloma (MM).