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Abstract
Multiple myeloma (MM) is a B-cell malignancy characterized by clonal expansion of plasma cells within the bone marrow, the presence of a serum and/or urine monoclonal protein, lytic bone lesions, and anemia. On a cellular level, the disease is characterized by complex interactions between tumor cells and the surrounding bone marrow microenvironment. Understanding of the relationship between malignant plasma cells and the microenvironment has sparked ongoing efforts to develop targeted therapeutic agents for treatment of this disease. The successful development of the first-in-class small-molecule proteasome inhibitor bortezomib occurred as a result of these efforts. This review focuses on the rationale for bortezomib therapy in the treatment of patients with newly diagnosed and relapsed MM, important treatment-related side effects, and future directions for use of bortezomib and other, emerging proteasome inhibitors.
Disclosures
JP Laubach: Advisory Board Novartis Pharmaceuticals. CS Mitsiades: Consultant Millennium Pharmaceuticals, Novartis Pharmaceuticals, and Kosan Pharmaceuticals. RL Schlossman: Speakers Bureau Celgene Corporation and Millennium Pharmaceuticals. Nikhil Munshi: Speakers Bureau Celgene Corporation and Millennium Pharmaceuticals; Advisory Board Celgene Corporation, Millennium Pharmaceuticals, and Novartis Pharmaceuticals. IM Ghobrial: Speakers Bureau Celgene Corporation, Millennium Pharmaceuticals, and Novartis Pharmaceuticals; research support Celegene Corporation and Millennium Pharmaceuticals. KC Anderson: Advisory Board Celgene Corporation, Millennium Pharmaceuticals; consultant Celgene Corporation and Millennium Pharmaceuticals; research support Celgene Corporation and Millennium Pharmaceuticals. PG Richardson: Advisory Board Celgene Corporation, Millennium Pharmaceuticals; Speakers Bureau Celgene Corporation and Millennium Pharmaceuticals.