Indications

Bortezomib is an injectable drug for adults approved for the treatment of:

Refractory or relapsed multiple myeloma (MM), including patients with previously untreated MM;

Relapsed or refractory mantle cell lymphoma (MCL), including previously untreated MCL.

Mechanism of Action

Bortezomib is a reversible, selective proteasome inhibitor, a targeted therapy. It works by inhibiting the proteasome, preventing the degradation of proteins within the cell, which leads to their accumulation, making it impossible for cancer cells to break down unwanted proteins, leading to cancer cell death. The proteasome is a cell structure that helps regulate the activity of proteins in cancer cells and healthy cells. This disruption causes cancer cell death. It can be used in combination with chemotherapy drugs, but it is not a chemotherapy drug by itself.

Side Effects

Targeted drug therapy may have fewer, milder, or different side effects than traditional chemotherapy. Bortezomib may cause the following side effects:

(1) Increased risk of infection: manifested by fever or chills, cough or hoarseness, back or side pain, painful or difficult urination

(2) Thrombocytopenia: abnormal bleeding or bruising, black, tarry stools, blood in urine or stool, or pinpoint red spots on the skin

(3) Nausea, vomiting, constipation, and diarrhea

(4) Stomach or intestinal blockage

(5) Swollen glands

(6) Thirst

(7) Cough, difficulty breathing, chest tightness

(8) Dizziness, drowsiness, fatigue

(9) Mouth ulcers, sores, or white spots

Severe reactions may occur:

(1) Tumor lysis syndrome (TLS)

Changes in the amount or frequency of urination, muscle or joint pain, stiffness or swelling, lower back, side or stomach pain, rapid weight gain, swelling in the feet or calves, or unusual tiredness or weakness

(2) Liver problems

Pain or tenderness in the upper abdomen, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellowing of the eyes or skin

(3) Thrombotic microangiopathy (damage to the smallest blood vessels), including thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS)

(4) Heart problems

Chest pain or discomfort, difficulty breathing, irregular heartbeat, or swelling in the feet, ankles, or legs