Bortezomib NEW

Bortezomib is a new targeted drug for myeloma, the discovery of the drug has been widely concerned by the medical community, its mechanism of action won the 2004 Nobel Prize in chemistry, in 2006 won the highest honor in the pharmaceutical industry - the international Galen Award (PrixGalien), known as "the revolution of tumor treatment, multiple myeloma treatment of major progress." Before Bortezomib, multiple myeloma was a nightmare for patients with the disease. As a breakthrough drug for myeloma, Bortezomib's advantages are mainly reflected in the following aspects:

1. Fast onset, only about 1 month to take effect;

2. The curative effect is significant, the remission rate can reach more than 80%, and the complete remission rate can reach 30% to 40%. The study SWOS0777, published in the Lancet in 2017, showed that bortezomide combined with lenalidomide and dexamethasone (BRD) regimen extended the median survival of patients by 11 months compared with lenalidomide combined with dexamethasone (RD) regimen, and the median survival of patients in the BRD regimen reached 75 months.

3. High safety, can be applied to patients with renal insufficiency or even renal failure, the efficacy is equivalent to that of patients with normal renal function, and can reverse renal function;

4. Bortezomib based induction therapy can significantly increase the amount of stem cell collection and significantly accelerate the rate of stem cell collection.

Adverse reaction

The most common adverse reactions were nausea, fatigue, diarrhea, constipation, thrombocytopenia, fever, vomiting and anorexia. Contraindicated in patients with severe liver damage or allergy to bortezomib, boron, or mannitol.

Indication

Bortezomib was the first proteasome inhibitor to be used clinically. The proteasome is present in all eukaryotic cells and degrades more than 80% of the proteins in the cell. It can reversibly inhibit the function of proteasome, thus inhibiting protein degradation, leading to protein accumulation and apoptosis. Because multiple myeloma (MM) constantly replicates and secretes myeloma proteins, it is more sensitive to proteasomes than normal cells and can be used as a second-line treatment for MM and mantle cell lymphomas.