Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Jul;49(3):228-42.
doi: 10.1053/j.seminhematol.2012.04.010.

Bortezomib combination therapy in multiple myeloma

Prashant Kapoor  1 , Vijay Ramakrishnan, S Vincent Rajkumar
Affiliations
Review

Bortezomib combination therapy in multiple myeloma

Prashant Kapoor et al. Semin Hematol. 2012 Jul.

Abstract

Bortezomib was approved for the treatment of multiple myeloma (MM) in 2003. Since then several bortezomib-based combination therapies have emerged. Although some combinations have been preceded by preclinical investigations, most have followed the inevitable process in which active (or potentially active) drugs are combined with each other to create new treatment regimens. Regimens that have combined bortezomib with corticosteroids, alkylating agents, thalidomide, and/or lenalidomide have resulted in high response rates. Despite the higher and often deeper response rates and prolongation of progression-free survival with bortezomib-based multiagent regimens, an overall survival (OS) advantage has not been demonstrated with most combinations compared to the sequential approach of using anti-myeloma agents, particularly in patients less than 65 years of age with newly diagnosed myeloma. The unique properties of some of these regimens can be taken into account when choosing a particular regimen based on the clinical scenario. For example, the combination of bortezomib, thalidomide, and dexamethasone (VTD) has particular value in renal failure since none of the drugs need dose modification. Similarly, the combination chemotherapy regimen VDT-PACE (bortezomib, dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide, and etoposide) is of particular value in patients presenting with aggressive disease such as extramedullary plasmacytomas or plasma cell leukemia. Ongoing clinical trials are testing combinations of bortezomib with several other classes of agents, including monoclonal antibodies, and inhibitors of deacetylases, heat shock proteins, phosphatidyl inositol 3-kinase/Akt/mammalian target of rapamycin pathway and farnesyl transferase.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rajkumar SV, Richardson PG, Hideshima T, Anderson KC. Proteasome inhibition as a novel therapeutic target in human cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2005;23(3):630–639. doi: 10.1200/JCO.2005.11.030. Prepublished on 2005/01/22 as. - DOI - PubMed
    1. Richardson PG, Barlogie B, Berenson J, et al. A phase 2 study of bortezomib in relapsed, refractory myeloma. The New England journal of medicine. 2003;348(26):2609–2617. doi: 10.1056/NEJMoa030288. Prepublished on 2003/06/27 as. - DOI - PubMed
    1. Kumar SK, Lee JH, Lahuerta JJ, et al. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: A multicenter international myeloma working group study. Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, UK. 2012;26(1):149–157. doi: 10.1038/leu.2011.196. Prepublished on 2011/07/30 as. - DOI - PMC - PubMed
    1. Orlowski RZ, Stinchcombe TE, Mitchell BS, et al. Phase I trial of the proteasome inhibitor PS-341 in patients with refractory hematologic malignancies. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2002;20(22):4420–4427. Prepublished on 2002/11/15 as. - PubMed
    1. Richardson PG, Barlogie B, Berenson J, et al. Extended follow-up of a phase II trial in relapsed, refractory multiple myeloma∷ final time-to-event results from the SUMMIT trial. Cancer. 2006;106(6):1316–1319. doi: 10.1002/cncr.21740. Prepublished on 2006/02/14 as. - DOI - PubMed

MeSH terms