Velcade Review

Multiple myeloma is the second most common blood cancer. It is more prevalent amongst older people, often diagnosed between 65 and 70 years of age. The cure for multiple myeloma is rare, with few effective treatment options. The initial therapy, for those young and fit, is bone marrow ablation with high dose chemotherapy and subsequent rescue with autologous stem cell transplant (ASCT). For those unable to withstand this, combination chemotherapy is employed.

Bortezomib (Velcade) is a first-in-class proteosome inhibitor that targets a specific protein pathway controlling a cell’s growth and degradation. According to a recent review by Dicato M et al reported in Oncology and published online in February 2007, bortezomib has shown remarkable efficacy in multiple myeloma. Bortezomib has been shown to increase patients’ responses, especially those with relapse and refractory disease, by inhibiting tumour growth, metastasis, and angiogenesis (formation of blood vessels in the tumour). The review concluded that Velcade, alone or in combination with dexamethasone, should be used as soon as possible in patients with multiple myeloma to increase response. In addition, Velcade is useful as a first-line treatment, and is effective and well tolerated in special patient populations, such as the elderly and patients with renal impairment. Finally, the report suggested that "Bortezomib, with its targeted mechanism of action, excellent efficacy, and predictable, manageable toxicities, may become the backbone of treatment for multiple myeloma". According to another study published in the journal of Oncology in 2006 by Fisher and his colleagues, Velcade, is useful and safe in patients with relapsed or refractory mantle cell lymphoma (MCL). Other studies are underway investigating combination of Velcade with standard drugs in patients with untreated, relapsed and refractory MCL, with promising early results.