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Drugs that block the cell's protein-recycling machine. Myeloma cells make huge amounts of antibody protein and choke on the backlog when the proteasome is blocked; normal cells cope far better.
Bortezomib (2003) was the first, given subcutaneously to limit neuropathy; carfilzomib is irreversible and more potent but has cardiovascular toxicity; ixazomib is oral. They pair with immunomodulatory drugs and dexamethasone in VRd/KRd induction, in relapsed combinations with daratumumab or isatuximab, and bortezomib is also used in mantle cell lymphoma and AL amyloidosis. Resistance and the shift to CD38 antibodies, CAR-T and bispecifics have reduced their role at relapse, but they remain in nearly every first-line regimen.
Ball-and-stick model from PubChem 2D record (no 3D conformer available). PubChem record
Showing the molecule this term concerns: Bortezomib.
Shares Newly diagnosed multiple myeloma, transplant-ineligible, Plasma cell leukaemia, Newly diagnosed multiple myeloma, transplant-eligible, Bortezomib.
Shares Plasma cell leukaemia, Newly diagnosed multiple myeloma, transplant-eligible, Relapsed or refractory multiple myeloma.
Shares Ixazomib, Bortezomib, Multiple myeloma.
Shares Newly diagnosed multiple myeloma, transplant-ineligible, Plasma cell leukaemia, Newly diagnosed multiple myeloma, transplant-eligible, Bortezomib.
Shares Newly diagnosed multiple myeloma, transplant-ineligible, Newly diagnosed multiple myeloma, transplant-eligible, Relapsed or refractory multiple myeloma, Multiple myeloma.
Shares Newly diagnosed multiple myeloma, transplant-ineligible, Newly diagnosed multiple myeloma, transplant-eligible, Relapsed or refractory multiple myeloma, Multiple myeloma.
Shares Newly diagnosed multiple myeloma, transplant-ineligible, Newly diagnosed multiple myeloma, transplant-eligible, Multiple myeloma.
Shares Plasma cell leukaemia, Newly diagnosed multiple myeloma, transplant-eligible, Multiple myeloma.