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Bortezomib (marketed as Velcade™ by Millennium Pharmaceuticals) is a "first-in-class" proteasome inhibitor. It is the best studied of a next generation of anti-myeloma drugs, and is also a potential treatment for plasma cell leukemia.
Bortezomib works by blocking the action of 26S proteasome, which is a multicatalytic enzyme whose function is to degrade abnormal or misfolded proteins targeted for destruction. There is emerging evidence that 26S proteasome plays a role in myeloma and lymphoma.
The Multiple Myeloma Research Foundation was responsible for a substantial amount of the funding for the development and testing of this drug.
Side effects
Bortezomib is associated with peripheral neuropathy in 30% of patients; occasionally, it can be painful. This can be worse in patients with pre-existing neuropathy. In addition, myelosuppression as neutropenia and thrombocytopenia can also occur and be dose limiting.
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