This Article Full Text Full Text (PDF) CME: Take the course for this article: A Practical Update on the Use of Bortezomib in the Management of Multiple M... eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by San Miguel, J. Articles by Ludwig, H. Search for Related Content PubMed PubMed Citation Articles by San Miguel, J. Articles by Ludwig, H.

A Practical Update on the Use of Bortezomib in the Management of Multiple Myeloma

^a Hospital Clinico Universitario de Salamanca, Salamanca, Spain; ^b Institut d’Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; ^c University of Turin, Turin, Italy; ^d St. Bartholomew’s Hospital, London, United Kingdom; ^e University of Bonn, Bonn, Germany; ^f St Vincent’s Comprehensive Cancer Center, New York, New York, USA; ^g Winship Cancer Institute, Atlanta, Georgia, USA; ^j Virchow-University Hospital, Berlin, Germany; ^h Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA; ⁱ Erasmus Medical Center, Rotterdam, The Netherlands

Key Words. Bortezomib • Multiple myeloma • Practical guidelines • Treatment

Correspondence: Jesús. San Miguel, M.D., Hematology Department, Hospital Clinico Universitario de Salamanca, Servicio de Hematologia, Paseo de San Vicente 58, Salamanca E-37007, Spain. Telephone: 00-34-923-29-1384; Fax: 00-34-923-29-4624; Mobile: 00-34-620-39-68-18; e-mail: sanmigiz{at}usal.es

Despite intensive therapy, multiple myeloma (MM) remains an incurable disease, and novel treatment approaches are therefore needed to improve outcome. Bortezomib is the first proteasome inhibitor to be approved by the U.S. Food and Drug Administration (FDA) and the European Agency for the Evaluation of Medicinal Products for the treatment of refractory or relapsed MM following the failure of at least two prior lines of therapy. Recently, it also received approval from the FDA for use as a second-line agent. An expert panel of hematologists met at the Ninth Congress of the European Hematology Association to review clinical data and experience in the treatment of MM with bortezomib, including bortezomib-based combination therapy. The conclusions of this expert panel, together with updated clinical data from the American Society of Hematology 46th Annual Meeting, provide a practical update on the use of bortezomib in MM. Bortezomib has demonstrated significant antitumor activity as a single agent in refractory and/or relapsed MM, with a significantly longer survival than with dexamethasone (1-year overall survival rate of 80% vs. 66%) and a 78% longer median time to progression. In combination therapy, patient responses suggest the possibility of chemosensitization and synergy. Furthermore, bortezomib does not appear to have an adverse effect on subsequent stem cell therapy. Bortezomib is well tolerated; most side effects are only mild to moderate and are manageable. Information is given on the practical management of the most common adverse events, including peripheral neuropathy and thrombocytopenia, and the use of bortezomib in renal and hepatic impairment.

This article has been cited by other articles:

				A. A. Argyriou, G. Iconomou, and H. P. Kalofonos Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature Blood, September 1, 2008; 112(5): 1593 - 1599. [Abstract] [Full Text] [PDF]

				J. R. Murillo Jr, J. E. Cox, and M. S. Oholendt An Overview of Chemotherapy-Induced Peripheral Neuropathy Journal of Pharmacy Practice, April 1, 2008; 21(2): 138 - 145. [Abstract] [PDF]

				E. Colado, S. Alvarez-Fernandez, P. Maiso, J. Martin-Sanchez, M. B. Vidriales, M. Garayoa, E. M. Ocio, J. C. Montero, A. Pandiella, and J. F. San Miguel The effect of the proteasome inhibitor bortezomib on acute myeloid leukemia cells and drug resistance associated with the CD34+ immature phenotype Haematologica, January 1, 2008; 93(1): 57 - 66. [Abstract] [Full Text] [PDF]

				F. Zhang, A. J. Paterson, P. Huang, K. Wang, and J. E. Kudlow Metabolic Control of Proteasome Function Physiology, December 1, 2007; 22(6): 373 - 379. [Abstract] [Full Text] [PDF]

				L. Rosinol, A. Oriol, M. V. Mateos, A. Sureda, P. Garcia-Sanchez, N. Gutierrez, A. Alegre, J. J. Lahuerta, J. de la Rubia, C. Herrero, et al. Phase II Pethema Trial of Alternating Bortezomib and Dexamethasone As Induction Regimen Before Autologous Stem-Cell Transplantation in Younger Patients With Multiple Myeloma: Efficacy and Clinical Implications of Tumor Response Kinetics J. Clin. Oncol., October 1, 2007; 25(28): 4452 - 4458. [Abstract] [Full Text] [PDF]

				T. Forslund, A. Sikio, and J. Anttinen IgA nephropathy in a patient with IgG lambda light-chain plasmacytoma: a rare coincidence Nephrol. Dial. Transplant., September 1, 2007; 22(9): 2705 - 2708. [Full Text] [PDF]