Bortezomib – Multiple Myeloma
Bortezomib is a highly effective antineoplastic agent and the first-in-class proteasome inhibitor. It targets specific enzyme complexes (proteasomes) that regulate protein stability within the cell. When proteasome function is blocked, toxic proteins accumulate inside the malignant cell, triggering programmed cell death (apoptosis). The drug has fundamentally changed the treatment landscape for multiple myeloma, enabling deep remissions even in advanced stages of the disease.
Bortezomib acts selectively, exerting a more potent effect on tumor cells than on the body's healthy tissues.
Indications
- Multiple Myeloma: As monotherapy or in combination with other agents (such as melphalan, prednisone, or dexamethasone) for previously untreated patients or those with relapsed disease.
- Mantle Cell Lymphoma (MCL): For patients who have received at least one prior standard therapy.
Dosage and administration
The medication is administered only by medical professionals. It can be given via two routes: intravenous (injection over 3–5 seconds) or subcutaneous. Subcutaneous administration is often preferred as it reduces the risk of nerve damage.
- Administration Schedule: The dose is individualized based on body surface area ($mg/m^2$). A standard cycle typically lasts 21 or 35 days, with the drug administered on specific days (e.g., Days 1, 4, 8, and 11).
- Breaks: At least 72 hours must pass between consecutive doses.
- Important note: Maintaining adequate hydration is essential during therapy to prevent dehydration and protect renal function.
