Bortezomib (Velcade®) is proteosome inhibitor with a specific effect different from other anti-cancer drugs. Velcade was found to be one of the most effective anti-myeloma drug available at the time. Clinical trials evaluated its efficacy and the validation reports were satisfactory for advanced stages of the disease. That is why this drug is administred to patients with failed prior therapies. Multiple myeloma is still not curable but Velcade-based therapy may provide a significant survival benefit.
The drug is administred to patients after at least second relapse having undergone conventionnal or high-dose therapy or to patients with first relapse resistent to conventional treatment or to high-dose chemotherapy. Velcade is administered as an intravenous injections. Velcade in combination with dexamethasone (corticoids in general) has shown additive and synergic effects compared with single agent treatments. Considering the fact that Valcade-based regimen represent a costly option, the approved indication is strictly controlled and its administration is recommanded only in large cancer centres ensuring high level of experience and multiple myeloma expertise. Bortezomib is still not approved in newly diagnosed patients but randomised clinical trials are being initiated to assess the first line therapy patients´ outcome.