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. 2024 Oct 22;10(21):e39698. doi: 10.1016/j.heliyon.2024.e39698

Table 4.

Summary of comparisons of treatment regimens identified from the literature search.

Regimen 1 Regimen 2 Study conclusion References
TBD T-VAD Both regimens were effective in treating patients with NDMM. [44]
Low-dose thalidomide regimen High-dose thalidomide regimen The incidence of grade 3 or higher adverse events was considerably higher in the high-dose group than in the low-dose group. [32]
Bortezomib regimen Non-bortezomib regimen Light-chain MM patients had more aggressive disease courses and worse outcomes, which could be improved with bortezomib treatment. [68]
PAD CBd When compared to the PAD regimen, elderly patients treated with CBd demonstrated higher therapy advantages and a predictable safety profile. [69]
Bortezomib-containing regimen Thalidomide-containing regimen Patients above the age of 75 with extramedullary plasmacytoma fared poorly. Bortezomib-containing regimens had a greater CR. In terms of survival outcomes, no substantial improvement was noticed. [73]
Thalidomide-based regimen Bortezomib-based regimen Even with bortezomib-based therapy, patients with del (12p) had considerably worse PFS and OS. PFS and OS were improved in patients without del (12p13) after bortezomib-based therapy vs. thalidomide-based therapy. Bortezomib-based therapy did not improve the poor survival of del patients (12p13). [74]
Bortezomib-containing regimen Non-bortezomib regimen Combination chemotherapy based on bortezomib can enhance the prognosis of NDMM in individuals with RI and should be regarded as first-line therapy. [75]
Bortezomib-based regimen Thalidomide-based regimen In the thalidomide-based group, there was a substantial difference in survival across the three ISS stages, but not between ISS stages I and II in the bortezomib-based group. The data show that bortezomib may have the capacity to partially offset the negative effect of risk variables on survival, particularly at a later stage of the ISS system. [76]
Conventional VTD Improved VTD The revised VTD regimen, which switched bortezomib from intravenous to subcutaneous administration, had noninferior efficacy to the regular VTD regimen, as well as a better safety profile and fewer side events. [38]
Conventional bortezomib Modified bortezomib (increased dose once weekly) Increased-dose, weekly bortezomib-based combination therapies did not perform worse than standard treatments in terms of response and survival benefit, but they did have a reduced rate of peripheral neuropathy. [28]
Subcutaneous group Intravenous group Subcutaneous bortezomib has been linked to improved tolerance; however, intravenous treatment resulted in a faster and deeper response. [43]
Bortezomib standard therapy Bortezomib weekly regimen The once-weekly bortezomib regimen was as effective as normal therapy, although the incidence of thrombocytopenia was reduced when compared to conventional therapy. [77]
High-dose (1.6 mg/m2) bortezomib regimen Low-dose (1.3 mg/m2) bortezomib regimen High-dose bortezomib as an induction regimen resulted in a higher CR rate, particularly in individuals 65 years and above or with R-ISS stage III and is feasible for youthful and high-risk patients. [36]
Thalidomide group Bortezomib group The survival advantage acquired by the t(14; undefined) group in the bortezomib-based group was substantially greater than the t(11; 14) and t(4; 14)/t(14; 16) groups. Notably, t(14; undefined) was discovered to be an independent predictor of longer OS. [78]
Lenalidomide group Non-lenalidomide group In both the single-hit and multi-hit groups, the ORR of the VRD group was considerably higher than that of the non-VRD group. In terms of ASCT, tandem-ASCT improved the 2-year PFS and OS of multi-hit MM considerably. [79]
RAD PAD RAD induction exhibited comparable efficacy to PAD and a considerably superior safety profile, as well as enhanced patient quality of life and reduced occupational stress for doctors. [45]
Bortezomib with thalidomide regimen Thalidomide or non-bortezomib with thalidomide regimens Bortezomib-containing regimens were more effective than thalidomide as first-line therapy, albeit at the expense of additional outpatient visits and higher total expenses. [80]
Chinese herbal medicine Non-Chinese herbal medicine The results indicated that patients with MM could benefit from Chinese herbal medicine treatment, potentially improving survival rates in Taiwan. [81]
Non-first-line bortezomib First-line bortezomib The PFS of patients receiving first-line bortezomib treatment with transplantation differed significantly. [23]
VAD-chemosensitive regimen Bortezomib/thalidomide in less chemosensitive regimen The staged method demonstrated a cost-effective use of expensive targeted drugs while maintaining a high CR and OS. [64]

ASCT: Autologous stem cell transplantation; CBd: Cyclophosphamide–bortezomib–low-dose dexamethasone; CR: Complete response; ISS: International Staging System; MM: Multiple myeloma; Non-V/T: Non-bortezomib or thalidomide; ORR: Overall response rate; OS: Overall survival; PAD: Bortezomib–doxorubicin–dexamethasone; PFS: Progression-free survival; RAD: Lenalidomide–doxorubicin–dexamethasone; RI: Renal impairment; R-ISS: Revised-International Staging System; TBD: Thalidomide-bortezomib–dexamethasone; T-VAD: Thalidomide combined with vincristine–doxorubicin–dexamethasone; VAD: Vincristine–doxorubicin–dexamethasone; VRD: Bortezomib–lenalidomide–dexamethasone; VTD: Bortezomib–thalidomide–dexamethasone.