Velcade and Thalomid – pro
Bortezomib is a first-in-class proteasome inhibitor that has shown remarkable efficacy in multiple myeloma. Bortezomib specifically targets the ubiquitin-proteasome pathway; the proteasome plays a key role in the degradation of ubiquinated proteins in general, and specifically proteins that control tumor cell growth and survival. By targeting the proteasome and acting on the multiple myeloma cells as well as the microenvironment, bortezomib has been shown to increase response in patients with multiple myeloma, especially in patients with relapsed and refractory disease. There was first a positive phase II study: Bortezomib, Thalidomide, and Dexamethasone in Treating Patients With Relapsed or Refractory Multiple Myeloma, NCT00124579, and ti was confirmed by a subsequent study. NICE recommends bortezomib and thalidomide as possible first treatment of multiple myeloma. Cavo at all reported good results specifically in a setting prior to transplant. Most oncologists are now using lenalidomide with Velcade, but thalidomide is also supported by the literature.
Tahir Latif, Nabeel Chauhan, Rashid Khan, Andrea Moran and Saad Z Usmani, Thalidomide and its analogues in the treatment of Multiple Myeloma
Experimental Hematology & Oncology 20121:27.
Bortezomib and thalidomide for the first‑line treatment of multiple myeloma
NICE technology appraisal guidance [TA228] Published date: July 2011 https://www.nice.org.uk/guidance/ta228/chapter/guidance
http://nccn.org/professionals/physician_gls/PDF/myeloma.pdf, 2016
Cavo M, Tacchetti P, Patriarca F, Petrucci MT, Pantani L, Galli M, et al. Bortezomib with thalidomide plus dexamethasone compared with thalidomide plus dexamethasone as induction therapy before, and consolidation therapy after, double autologous stem-cell transplantation in newly diagnosed multiple myeloma: a randomised phase 3 study. Lancet. 2010 Dec 18. 376(9758):2075-85.
Kaufman JL, Nooka A, Vrana M, Gleason C, Heffner LT, Lonial S. Bortezomib, thalidomide, and dexamethasone as induction therapy for patients with symptomatic multiple myeloma: a retrospective study. Cancer. 2010 Jul 1. 116(13):3143-51