Bortezomib for the treatment of multiple myeloma

Abstract

Bortezomib is the first proteasome inhibitor drug tested in human patients. Bortezomib demonstrates a particular clinical utility in the treatment of multiple myeloma (MM), where it is the only one of the new drugs administered as mono-therapy that prolongs survival. The significant problem for the consistent pursuit of bortezomib was neurotoxicity, which has been significantly reduced by registering subcutaneous administration or being administered once per week. Bortezomib is currently approved for the treatment of patients with progressive MM in mono-therapy and in combination with prednisone and melphalan in cases of untreated patients who are not candidates for autologous hematopoietic stem cell transplantation (AHSCT) and in combination with dexamethasone or dexamethasone and thalidomide in untreated MM patients, who are candidates for treatment AHSCT. Clinical research is focused on the combination of bortezomib with other new drugs with the hope of further optimizing the treatment of patients with multiple myeloma.

Keywords::

• bortezomib
• efficacy
• guidelines
• multiple myeloma
• proteosome inhibitor
• recommendations
• safety
• treatment

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Bortezomib is the first proteasome inhibitor drug tested in human patients, causing tumor cell death by degradation of key proteins. It acts in a very selective and reversible way.

• It was approved by the US FDA on an accelerated basis for treatment of relapsed or resistant multiple myeloma patients due to the very impressive results from Phase II trials, and currently also for the treatment of untreated patients.

• Bortezomib is widely used in induction and consolidation regimens. The research has been conducted on the optimal use in autologous hematopoietic stem cell transplantation and maintenance therapy.

• Demonstration of less neurological toxicity, particularly through the introduction of the subcutaneous administration of bortezomib, increases the chance of managing the intended treatment plan, and thus the effectiveness of therapy.

• Currently, further research is being conducted on the combination of bortezomib with new agents in multiple myeloma.

Notes