A genetic variant study of bortezomib-induced peripheral neuropathy in Chinese multiple myeloma patients

Background:Bortezomib results in peripheral neuropathy(PN)in approximately 50%of patients,during multiple myeloma(MM)treatment,a complication known as Bortezomib-induced peripheral neuropathy(BIPN).The drug response varies among individuals.Genetic factor may play an important role in BIPN.Methods:A nextgeneration sequencing(NGS)panel containing 1659 targets from 233 genes was used to identify risk variants for developing BIPN in 204 MM patients who received bortezomib therapy.mRNA expression of MTHFR and ALDH1A1 in 62 peripheral blood samples was detected by real-time quantitative PCR(RT-qPCR).Serum homocysteine(Hcy)levels were detected in 40 samples by chemiluminescent microparticle immunoassay(CMIA).Results:Compared with the non-BIPN group(n=89),a total of 8 significantly associated single nucleotide polymorphisms(SNPs)were identified in the BIPN group(n=115):MTHFR(rs1801131,rs1801133,rs17421511),EPHX1(rs1051740),MME(rs2016848),ALDH1A1(rs6151031),HTR7(rs1935349)and CYP2A6(rs8192720).The mRNA expression level of MTHFR in newly diagnosed patients with peripheral neuritis after treatment(NP group)was lower than that of newly diagnosed patients without peripheral neuritis after treatment(NnP group)(1.70±0.77 vs.2.81±0.97,p=0.009).Serum Hcy levels were significantly higher in BIPN group than in non-BIPN group(11.66±1.79μmol/L vs.8.52±3.29μmol/L,p=0.016)and healthy controls(11.66±1.79μmol/L vs.8.55±2.13μmol/L,p≤0.001).Conclusion:CYP2A6,EPHX1,MTHFR,ALDH1A1,HTR7,MME and BIPN are linked in Chinese MM patients.BIPN is more likely to occur in patients with lower MTHFR mRNA expression,which might result in higher serum Hcy levels.

Treatment Efficacy and Safety of Bortezomib Combined with Dexamethasone and Lenalidomide Chemotherapy Regimen for Multiple Myeloma

Objective:To analyze the effect of bortezomib combined with dexamethasone and lenalidomide in the treatment of multiple myeloma.Methods:60 cases of multiple myeloma patients admitted to our hospital from January 2022 to December 2023 were selected randomly,with 30 cases in each group.Bortezomib combined with dexamethasone was administered in the control group,and bortezomib combined with dexamethasone and lenalidomide was given to the observation group,and the treatment effect was analyzed.Results:After treatment,CD^(3+)and CD^(4+)of the observation group were higher than that of the control group,CD^(8+)was lower than that of the control group,and the total treatment efficiency was higher,which was statistically significant(P<0.05),and there was no difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Bortezomib combined with dexamethasone and lenalidomide is effective in the treatment of multiple myeloma as it regulates the immune function and is safe,thus it can be promoted in clinical practice.

Lactate Decreases Bortezomib Sensitivity and Predicts Poor Clinical Outcomes of Multiple Myeloma

Objective:Metabolic disorders are regarded as hallmarks of multiple myeloma(MM)and are responsible for rapid cancer cell proliferation and tumor growth.However,the exact biological roles of metabolites in MM cells have not been fully explored.This study aimed to explore the feasibility and clinical significance of lactate for MM and investigate the molecular mechanism of lactic acid(Lac)in the proliferation of myeloma cells and cell sensitivity to bortezomib(BTZ).Methods:Metabolomic analysis of the serum was carried out to obtain metabolites expression and clinical characteristics in MM patients.The CCK8 assay and flow cytometry were used to detect cell proliferation,apoptosis,and cell cycle changes.Western blotting was used to detect the potential mechanism and apoptosis-and cycle-related protein changes.Results:Lactate was highly expressed in both the peripheral blood and bone marrow of MM patients.It was significantly correlated with Durie-Salmon Staging(DS Staging)and the International Staging System(ISS Staging)and the serum and urinary involved/uninvolved free light chain ratios.Patients with relatively high lactate levels had a poor treatment response.Moreover,in vitro experiments showed that Lac could promote the proliferation of tumor cells and decrease the proportion of G0/G1-phase cells,which was accompanied by an increased proportion of S-phase cells.In addition,Lac could decrease tumor sensitivity to BTZ by disrupting the expression of nuclear factor kappa B subunit 2(NFκB2)and Re1B.Conclusion:Metabolic changes are important in MM cell proliferation and treatment response;lactate could be used as a biomarker in MM and as a therapeutic target to overcome cell resistance to BTZ.

Bortezomib-Induced Bilateral Eye Swelling and Cutaneous Adverse Reaction in a Patient with Plasma Cell Leukemia—A Case Report

Bortezomib, a proteasome inhibitor, is an established therapy against plasma cell leukemia—a variant of plasma cell dyscrasias. Its most frequent side effects have been listed as peripheral neuropathy, neuropathic pain, thrombocytopenia, and gastrointestinal problems. Allergic skin reaction is a rarely documented side effect in patients receiving bortezomib-based chemotherapy. A combination therapy consisting of intravenous bortezomib, oral Revlimid tablets, and oral dexamethasone tablets has been prescribed for the patient after his recent diagnosis of plasma cell leukemia. While receiving his third treatment cycle, he developed an allergic reaction (skin rash) involving the neck, and wrists, and mild bilateral eye swelling. The infusion was stopped immediately and then ciprofloxacin ophthalmic solution and oral diphenhydramine 25 mg were prescribed to the patient with significant improvement in his clinical condition. He was temporarily taken off bortezomib. At a follow-up visit a week later, a significant improvement was noticed in his condition. Rash had reduced on neck and wrists, and eye swelling had reduced as well. As of the time of writing this case report, he has been temporarily taken off bortezomib, but other medications in the treatment regimen were continued as prescribed.

PCI-32765和Bortezomib对B细胞肿瘤细胞系细胞增殖、凋亡的影响及其机制的研究

本研究旨在探讨Btk抑制剂PCI-32765和蛋白酶体抑制剂bortezomib对Raji、Ramos细胞的增殖、凋亡的影响及其作用机制。PCI-32765和bortezomib单药及联合用药处理Raji和Ramos细胞后,分别运用CCK-8法及流式细胞术检测细胞的增殖与凋亡,Western blot法检测Btk、NFκB、c-IAP1、Bcl-xL、caspase-3等蛋白的表达。结果表明:①PCI-32765(0.5、1.0、2.0、3.0、4.0、5.0、6.0μmol/L)和bortezomib(10、20、30、40、50、60、80 nmol/L)处理Raji和Ramos细胞48 h,均可抑制细胞增殖,抑制率呈剂量依赖性,且两药具有协同作用;②PCI-32765(2.0μmol/L)、bortezomib(20 nmol/L)单药及联合用药处理Raji和Ramos细胞不同时间(8、12、24、36、48、72 h),均可抑制细胞存活率,抑制率呈时间依赖性,且两药具有协同作用;③PCI-32765(2μmol/L)和bortezomib(20 nmol/L)单药及联合用药处理Raji和Ramos细胞48 h,可明显促进Raji及Ramos细胞的凋亡。Raji细胞实验结果,空白对照组、PCI-32765和bortezomib单药组、联合用药组的细胞凋亡率分别为10.34±0.53%、24.26±0.91%、43.66±1.08%与74.06±0.72%,各组间有统计学差异(P<0.05);Ramos细胞实验结果,空白对照组、PCI-32765和bortezomib单药组、联合用药组的细胞凋亡率分别为15.16±1.49%、71.36±0.82%、75.32±2.36%与84.30±0.91%,各组间有统计学差异(P<0.05);④PCI-32765和bortezomib单药处理Raji、Ramos细胞后,细胞内Btk、NFκB、Bcl-xl及cIAP1的表达水平较对照组降低,Caspase-3的表达水平升高,两药联用后,作用增强。结论:PCI-32765和bortezomib可以协同抑制Raji与Ramos细胞的增殖,促进其凋亡,其机制可能与抑制Btk、NFκB的活性,下调Bcl-xl及c-IAP1等抗凋亡蛋白,同时上调Caspase-3等凋亡蛋白的表达而发挥作用。

Bortezomib或联合三尖杉酯碱、三氧化二砷对急性髓系白血病原代细胞增殖作用的影响

目的:探讨bortezomib单独或联合三尖杉酯碱(HT)、三氧化二砷(As2O3)对初发及难治/复发急性白血病原代细胞的增殖作用。方法:以初发及难治/复发急性髓系白血病原代细胞为研究对象,分别应用bortezomib、HT、As2O3单独或联合处理细胞后,使用MTT法观察细胞增殖活力。结果:10～500nmol/L bortezomib对初发及难治/复发性白血病患者原代细胞均有抑制作用,且呈明显剂量依赖关系,随浓度增大抑制效果逐渐增强。作用于初发白血病原代细胞时,Bortezomib与HT联合与各单药处理组相比,抑制率无明显提高,而联合As2O3时其抑制率优于单药处理组;作用于难治/复发白血病原代细胞时,bortezomib与HT或As2O3联合效果均呈现相加作用,其中与As2O3联合效果优于与HT联合者。结论:Bortezomib能够抑制初发及难治/复发急性白血病原代细胞增殖,与As2O3联合作用后抑制效果明显增强。

Bortezomib增强三氧化二砷抑制KM3细胞生长和促凋亡机制的研究

目的:新的治疗药物及方法的出现大大提高了多发性骨髓瘤(MM)的疗效,但仍然无法使其治愈。为了寻求治疗药物及方法,提高单药或联合用药对MM的治疗效果。我们观察了三氧化二砷(ATO,As2O3)单药及联合硼替佐米(Velcade,PS-341)有无增强诱导MM细胞凋亡的作用,并初步探讨其机制。方法:检测ATO单药及联合硼替佐米对KM3细胞的影响。应用台盼蓝拒染法检测细胞活力,MTT(四甲基偶氮唑盐比色法)检测细胞生长抑制率。流式细胞术检测细胞的凋亡比例。应用RT-PCR方法检测p65mRNA的表达变化。应用Western blotting检测p65、p-p65、PARP、caspase-3、-8、-9蛋白表达的变化。结果:ATO抑制细胞生长,对KM3细胞p65mRNA及其蛋白没有显著影响,主要是通过激活caspase-3,-8,-9,诱导细胞凋亡。当与bortezomib联合用药时有协同促凋亡作用。结论:ATO单独作用于KM3细胞可以抑制其生长并诱导细胞凋亡,与bortezomib联用时有协同效应。

Bortezomib对炎症性肠病小鼠模型炎症抑制作用及机制的研究

目的观察Bortezomib能否通过抑制核因子-κB(nuclear factor-κB,NF-κB)活性起到治疗炎症性肠病(inflammatory bowel disease,IBD)的作用。方法 160只Balb/c小鼠随机分成Bortezomib高、中、低剂量治疗组,正常对照组和模型对照组,每组32只。DSS法构建IBD模型后,高、中、低治疗组分别予以Bortezomib溶液1.0 mg/kg、0.6 mg/kg、0.2 mg/kg腹腔注射,对照组予以PBS腹腔注射。分别于用药开始前、用药后1 d、3 d、7 d观察疾病活动指数(disease activity index,DAI)、组织学评分,ELISA法测定肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)的血清水平;EMSA法评估核NF-κB p65与DNA结合的活性。结果造模后,小鼠DAI、组织学评分、TNF-α水平和NF-κB p65活性均较正常对照组显著降低,而应用Bortezomib治疗后,NF-κB p65活性显著受到抑制,TNF-α水平均逐渐降低,且DAI、组织学评分也均显著降低,具有明显的时间和剂量依赖性。结论 Bortezomib对小鼠结肠炎动物模型具有保护作用,可能通过抑制NF-κB的活性,下调TNF-α的表达发挥作用。随着Bortezomib治疗剂量和治疗天数的增加,对NF-κB的活性抑制作用越来越明显,对IBD的治疗作用也越来越来明显。

Flavopiridol联合Bortezomib对多发性骨髓瘤的细胞增殖抑制作用

目的探讨细胞蛋白激酶抑制剂Flavopiridol及蛋白酶抑制剂Bortezomib在体内抑制多发性骨髓瘤细胞U266的细胞增殖作用及其机制。方法以不同浓度的Flavopiridol及Bortezomib分别、联合作用于U266细胞,用MTT法检测细胞增殖抑制作用。采用western blot法检测Bcl-2及Mcl-1表达变化;结果①Flavopiridol比Borte-zomib对U266细胞增殖抑制作用更强,IC50值分别为52.5nM,25nM。②与单独用药相比,Flavopiridol联合Borte-zomib作用于U266细胞,IC50值有明显的下降为17.5nM。③Flavopiridol及Bortezomib给药前后,Bcl-2蛋白表达无变化,而Mcl-1蛋白表达明显下降。结论 Flavopiridol联合Bortezomib用药能在体内明显抑制多发性骨髓瘤细胞U266的生长,其机制主要是通过诱导细胞凋亡来抑制增殖。

蛋白酶体抑制剂Bortezomib对人脑胶质瘤增殖抑制及诱导凋亡作用

目的探讨Bortezomib对体外SHG-44胶质瘤细胞株形态的影响及诱导凋亡作用。方法Bortezomib体外处理培养的SHG-44胶质瘤细胞后,采用MTT法检测细胞增殖、HE染色光镜观察、Hochest33342染色荧光显微镜观察以及锇铀铅染色透射电镜观察胶质瘤细胞的形态变化,流式细胞术分析细胞凋亡率及细胞周期。结果MTT显示Bortezomib抑制SHG-44胶质瘤的增殖与浓度和时间呈相关性;6.0μmol/L Bortezomib处理SHG-44胶质瘤细胞24 h后,光镜、荧光显微镜、透射电镜下均可见凋亡形态学改变。流式细胞术分析细胞凋亡率为(20.31±2.84)%(P<0.01);细胞周期变化显示S期细胞减少到(17.65±6.38)%(P<0.01),细胞周期被阻滞于G0/G1期和G2/M期,分别为(68.51±5.62)%(P<0.01)和(14.75±2.48)%(P<0.01)。结论Bortezomib抑制C6胶质瘤细胞的增殖并诱导其凋亡。

抗肿瘤治疗新药蛋白酶体抑制剂Bortezomib的临床应用

蛋白酶体抑制剂(proteasom e inh ib itor)通过抑制26S蛋白酶体活性,激活胱冬肽酶(caspase)-3诱导凋亡,抑制核因子(NF)-κB依赖性基因转录,影响细胞内多种信号级联,破坏维持机体正常内稳态的机制导致肿瘤细胞生长延迟或死亡。V e lcade(化学名Bortezom ib,前用名PS-341)是美国FDA批准的第一个已供临床应用的蛋白酶体抑制剂。临床用于治疗初治或复发性、难治性多发性骨髓瘤,其次为造血组织恶性肿瘤及进展性实体瘤等显示具有良好的抗瘤活性,安全性好,不良反应少。其临床应用研究正在迅速扩展中。

Bortezomib对非小细胞肺癌细胞系增殖、细胞周期及核转录因子活性的影响

目的探讨Bortezomib对非小细胞肺癌(NSCLC)细胞周期、增殖、凋亡及核转录因子(NF-κB)的影响。方法采用MTT法检测Bortezomib对细胞生长的抑制作用,流式细胞仪分析Bortezomib对细胞周期及凋亡的影响,Western blotting检测Borte-zomib对NF-κB、IκB和Bcl-2表达的影响。结果随着作用时间和药物浓度的增加,Bortezomib对NSCLC细胞的生长抑制作用越明显。25nmol/L的Bortezomib作用48h可以使细胞周期阻滞在G2/M期。6种NSCLC细胞中均有NF-κB的基础性表达,且胞核中NF-κB的表达水平与胞质IκB的表达水平呈反比。Bortezomib对细胞中NF-κB的基础表达水平没有影响,但能明显抑制TNF-α诱导的NF-κB的核转位,并下调抗凋亡蛋白Bcl-2的水平,且这种抑制作用呈时间和剂量依赖趋势。结论Bortezomib能够抑制NSCLC细胞增殖,并诱导凋亡发生,可能是通过NF-κB通路发挥作用。

蛋白酶体抑制剂Bortezomib的临床应用

Bortezomib是哺乳动物细胞中26S蛋白酶体糜蛋白酶样活性的可逆抑制剂，通过抑制核因子（NF—κB）诱导多发性骨髓瘤（MM）细胞（包括耐药细胞）凋亡，下调MM细胞与基质细胞表达的黏附分子，进而减少细胞因子的分泌，抑制耐药。临床研究表明，Bortezomib是治疗MM有前途的新药。现将Bortezomib的临床应用作一综述。

蛋白酶体抑制剂Bortezomib对NK细胞杀伤肝癌细胞活性的影响

目的探讨小剂量蛋白酶体抑制剂Bortezom ib对肝癌细胞MHCⅠ类分子(M ICA)的表达及NK细胞杀伤活性的影响。方法应用流式细胞仪和半定量RT-PCR检测肝癌细胞经小剂量蛋白酶体抑制剂Bortezom ib处理后M ICA表达水平。应用细胞毒实验和胞内染色检测NK细胞功能。结果肝癌细胞株或新鲜肝癌细胞经小剂量蛋白酶体抑制剂Bortezom ib处理后M ICA表达增加,进而促进经NKG2D途径介导的NK细胞杀伤活性。结论联合小剂量蛋白酶体抑制剂Bortezom ib和NK细胞为基础的免疫治疗有助于提高原发性肝细胞癌的综合治疗效果。

蛋白酶体抑制剂Bortezomib对宫颈癌Hela细胞的体外作用

目的探讨蛋白酶体抑制剂Bortezomib对宫颈癌Hela细胞存活率的影响。方法 MTT检测Bortezomib对宫颈癌Hela细胞体外生长及增殖的影响;并用Western印迹、RT-PCR检测NF-κB(P65)蛋白和mRNA表达水平的变化。结果 (1)MTT检测结果显示:与对照组相比,Borte-zomib 1.25μmol/L组〔(84.9±0.08)%〕、Bortezomib 2.50μmol/L组〔(67.1±0.12)%〕、Bortezomib 5.00μmol/L组〔(51.6±0.11)%〕、Bortezomib10.00μmol/L组〔(41.3±0.13)%〕及Bortezomib 20.00μmol/L组〔(20.8±0.12)%〕Hela细胞增殖率明显降低(P<0.05)。(2)Western印迹检测结果表明:随着Bortezomib浓度的增高,NF-κB(P65)蛋白表达量有剂量依赖性的降低趋势(P<0.05)。(3)RT-PCR结果显示,与对照组相比,随着Bortezomib浓度的增加,NF-κB(P65)mRNA的表达水平明显降低(P<0.05)。结论蛋白酶体抑制剂Bortezomib能够体外抑制宫颈癌Hela细胞的短期增殖,其机制与下调NF-κB(P65)的表达密切相关。

Bortezomib, dexamethasone plus thalidomide for treatment of newly diagnosed multiple myeloma patients with or without renal impairment

Objective： To investigate the efficacy and safety of the treatment of the newly diagnosed multiple myeloma （MM） with or without renal impairment receiving the therapy of bortezomib, dexamethasone plus thalidomide （BTD） regimen in order to analyze the effects of BTD regimen on the prognosis of the MM patients with renal impairment compared with the patients without renal impairment. Methods： Seventy-two newly diagnosed MM patients entered into our study and all the patients belonged to International Stage System （ISS） 3 in which transplantation patients were excluded or the patients refused receiving transplantation therapy. According to the level of serum creatinine （Scr）, the patients were divided into two groups including group 1 （n=42） （Scr 〈2 mg/dL） and group 2 （n=30） （Scr ≥2 mg/dL）. All the patients received the therapy of BTD regimen as induction therapy, and the median treatment time was 5 （range, 2-8） cycles. The outcome was analyzed retrospectively. Results： The overall remission （OR） rates were 81.0% （group 1） and 80.0% （group 2）. There was no statistical difference between the two groups （P〉0.05）. In group 2, 10 patients （33.3%） got renal function reversal, 14 patients （46.7%） got improved renal function and the median time to renal function reversal was 1.4 （range, 0.7-3.0） months. Among 12 patients with hemodialysis at diagnosis, 8 patients got rid of hemodialysis after median 4 cycles of therapy （range, 3-6 cycles）. After a median follow-up period of 16 （range, 2-31） months, 5 patients （11.9%） in group 1 died and 9 patients （30.0%） in group 2 died （P=0.056）. The 2-year estimate of overall survival was 77.3% in group 1 and 63.8% in group 2, respectively （P=0.188）. During a median follow-up time of 13.0 months （range, 2-25 months）, 15 patients （35.7%） in group 1 progressed and 13 patients （43.3%） in group 2 progressed （P=0.513）. The 2-year estimate of response duration was 50.6% in group 1 and 42.1% in group 2, respectively （P=1）. The main toxicities in the two groups included thrombocytopenia, peripheral neuropathy （PN）, infection, herpes zoster and so on. The incidence of grade 3 and 4 adverse events was low. Conclusions： BTD regimen may become the front-line therapy for the newly diagnosed MM patients with renal impairment because BTD regimen can improve the prognosis of the patients with renal impairment as good as the patients without renal impairment.

Once-versus Twice-weekly Bortezomib Induction Therapy with Dexamethasone in Newly Diagnosed Multiple Myeloma

In this study,we administered a modified schedule of weekly intravenous Bortezomib at 1.6 mg/m 2 with dexamethasone(BD) and compared it to the standard 1.3 mg/m 2 twice-weekly BD regimen in Chinese patients with newly diagnosed multiple myeloma(MM).We assessed the difference in efficacy,safety profile and survival between the once-weekly and twice-weekly cohorts(13 vs.24 patients).The over response rate was similar with both arms of the study,being 77% in the once-weekly schedule and 74.9% in the twice-weekly schedule(P=0.690).The median overall survival was not reached in either schedule.Also,the median progression-free survival and duration of response of the once-weekly schedule did not significantly differ from those of the twice-weekly schedule(8 months vs.10 months,P=0.545 and 6 months vs.7 months,P=0.467 respectively).Peripheral sensory neuropathy and grade 3/4 hematologic toxic effects were more frequently reported in the twice-weekly schedule than the once-weekly schedule,but there was no statistically significant difference.This preliminary experience in Chinese patients with newly diagnosed MM indicated that once-weekly infusion of Bortezomib plus dexamethasone may improve safety without affecting outcome.

新一类蛋白酶体抑制剂bortezomib

综述了bortezomib的药理作用、药动学及临床评价。本品是一种新型的蛋白酶体抑制剂,临床上用于复发性和难治性多发性骨髓瘤的治疗。

Determining the optimal time for bortezomib-based induction chemotherapy followed by autologous hematopoietic stem cell transplant in the treatment of multiple myeloma

In our study, we determined the efficacy of bortezomib-based induction therapy followed by autologous stem cell transplant （ASCT） in newly diagnosed and relapsed/refractory （R/R） multiple myeloma （MM） patients and compared the advantages of early versus late transplant. We used a retrospective analysis to examine 62 patients, including 46 cases of newly diagnosed MM （early transplant group） and 16 cases of relapsed/refractory MM （late transplant group）. All of these patients received bortezomib-based induction therapy followed by ASCT. The efficacy and side effects of the treatment regimen were analyzed. Patients＇ overall survival （OS） and progression-free survival （PFS） times were determined. The ratio of complete remission to near-complete remission （CR/nCR） was 69.5% versus 56.2% （P=0.361）, respectively, for the early transplant group versus the late transplant group, respectively, after receiving bortezomib-based induction therapy; the overall response rates of the two group were 91.3 % and 81.2 %, respectively （P=0.369）. After receiving ASCT, the CR/nCR of the two groups increased to 84.8% and 81.3%, respectively. The median time required for neutrophil engraftment of the early transplant group and the late transplant group was 11 and 14.5 days, respectively （P=0.003）; the median time required for platelet engra^nent was 13 and 21.5 days （P=0.031）, respectively. There were no significant differences in the toxic side effects observed during induction therapy and ASCT between the two groups. The OS of the two groups was not statistically different （P=0.058）. The PFS of the early transplant group and the late transplant group was 41.6 and 26.5 months, respectively （P=0.008）. Multivariate analysis demonstrated that the time of receiving ASCT, the types of M protein, and the International Staging System （ISS） stage were all independent factors that influenced PFS. In conclusion, patients in a suitable condition for ASCT should be recommended to have an early ASCT immediately after diagnosis.

Subcutaneous versus Intravenous Bortezomib Administration for Multiple Myeloma Patients：a Meta-analysis

Bortezomib,the first potent therapeutic proteasome inhibitor,has been suggested as a standard care in patients with newly diagnosed and relapsed multiple myeloma（MM）.However,evidence bearing on the efficacy and safety of subcutaneous（SC） versus intravenous（IV） administration of bortezomib for MM patients is controversial.Randomised controlled trials（RCTs） and observational studies were enrolled in our meta-analysis to investigate the efficacy and safety of bortezomib via SC vs.IV administration on MM patients.Sixteen trials with a total of 2575 patients with MM（SC,n=1191;IV,n=1384） were included in our meta-analysis.There were no significant differences between these two arms regarding overall response rate（ORR）,complete response（CR）,or very good partial response（VGPR）.The pooled RRs for rate of adverse events（AEs）,such as thrombocytopenia and bortezomib-induced peripheral neuropathy（BIPN）,were 0.79（95% CI：0.68–0.92） and 0.63（95% CI：0.51–0.79）,respectively.Moreover,there was much more largely decreased incidence of grade 3 and higher thrombocytopenia and BIPN in bortezomib SC administration than IV route.In general,alternative SC administration should be considered instead of IV administration in use of bortezomib for patients with MM.