Myelom-Gruppe Rhein-Main

Last modified: 12 January 2013

Treatment with Bortezomib

Updated brochure on Bortezomib (Velcade®)

The aims of this brochure are

  • to help you understand more about Velcade treatment
  • to answer some of the more common questions around Velcade
  • to help you make informed decisions about the treatment options available

To download a copy of this brochure, please klick here (268 KB PDF *)

Not all details of the manner of effect of this so-called proteasome inhibitor have yet been clarified. However, the following would appear certain: The formation and the breaking down of signal proteins are equally as important for the survival of the cancer cells as for the reproduction of cells, the adhesion of cells and the formation of new blood vessels. The breaking down of these proteins is controlled by so-called proteasomes. These are enzyme complexes that occur in both healthy as well as in cancer cells and break down marked intracellular proteins in a controlled manner.

Bortezomib inhibits the proteasomes, with the result that many signals in the cancer cell nullify each other reciprocally or are prevented. This, in turn, leads to the inhibiting of the tumour growth and of the formation of new blood vessels, the death of the cancer cells (apoptosis) and to the inhibiting of the interaction with conjunctive tissue cells of the bone marrow.

In Europe, Bortezomib was approved in April 2004 under the brand name Velcade® for the treatment of multiple myeloma, provided at least two preceding courses of therapy had been completed and progression of the illness had been observed during the final treatment (so-called third-line therapy). Since April 2005 Velcade® has also been approved for the treatment of patients with just one pre-treatment (so-called second-line therapy). In order to receive Velcade® as monotherapy (i.e. not in combination with another drug) patients should have already undergone a bone marrow transplantation or not be suitable for this. In September 2008, Velcade® was approved in combination with melphalan and prednisone for the treatment of patients with previously untreated multiple myeloma who are not eligible for high-dose chemotherapy with bone marrow transplant. The optimum duration of treatment with Velcade® is not yet known.

The most frequent side effects that occurred in the clinical studies with Velcade® were moderate degrees of fatigue, a feeling of being unwell, weakness, nausea, diarrhoea, a reduced appetite and constipation. Additionally, however, there may be a reduced concentration of blood platelets, peripheral neuropathy (numb feeling, a tingling sensation and/or pain in the hands, arms, feet or legs), high temperature, vomiting and anaemia. The occasional occurrence of high temperature, pneumonia, severe diarrhoea, vomiting, dehydration and dizziness were stated as serious side effects.

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