Bortezomib is a drug that belongs to the class of drugs called proteasome inhibitors. The proteasome is a protein complex that breaks down rusty and modified proteins that cells are meant to dispose off. Its housekeeping job is very important for the cells to keep functioning. Research studies have shown that if the proteasome is inhibited (or stopped from functioning) some cancer cells, including some lymphoma cells may find it difficult to carry out normal functions and even die. Bortezomib (Velcade) is a type of drug that inhibits proteasomes. Theoretically it can be efective in a wide spectrum of malignancies.
It has shown great results in the treatment of relapsed multiple myeloma, another type of cancer that affects the bone marrow. Trials that have tried Velcade in relapsed lymphomas over the past few years have resulted in good responses in certain types of lymphoma, especially Mantle Cell Lymphomas. Bortezomib (Velcade) has been granted approval for the treatment of relapsed or refractory Mantle Cell Lymphoma by the FDA in December 2006. It represents an important step in the approach to second-line treatments in Mantle Cell Lymphoma, a potentially difficult to treat lymphoma.
A number of trials in other lymphomas are ongoing. Phase II results of a clinical trial examining VELCADE® (bortezomib) in patients with previously untreated aggressive lymphoma were recently published in the Journal of Clinical Oncology. The study examined the efficacy of VELCADE in combination with the current standard of care (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone; R-CHOP) in 76 patients with two aggressive subtypes of lymphoma: mantle cell lymphoma (MCL) or diffuse large B-cell lymphoma (DLBCL). Among 35 evaluable DLBCL patients overall response rate was 100 percent, and the complete response rate was 86 percent. There is a great interest in Velcade in a specific type of lymphoma, GCB subtype of DLBCL with the NF-κB survival pathway, which is one of the pathways known to be inhibited by VELCADE.
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Bortezomib plus CHOP-rituximab for previously untreated diffuse large B-cell lymphoma and mantle cell lymphoma.
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