Bortecade

Multiple myeloma patients who have received at least 1 prior therapy & have demonstrated disease progression on the last therapy. Patients w/ mantle cell lymphoma who have received at least 1 prior therapy.

IV 1.3 mg/m² as 3-5 sec bolus inj twice wkly for 2 wk (days 1, 4, 8 & 11) followed by 10-day rest period (days 12-21). At least 72 hr should elapse between consecutive doses. Patient w/ confirmed complete response Recommended to receive 2 additional cycles beyond a confirmation. Responding patient w/o complete remission Recommended to receive a total of 8 cycles. Grade 3 non-hematological or 4 hematological toxicity excluding neuropathy May be reinitiated at 25% reduced dose (1.3 mg/m² reduced to 1 mg/m²; 1 mg/m² reduced to 0.7 mg/m²) once symptoms of toxicity have resolved. Grade 1 w/ pain or grade 2 peripheral neuropathy Reduce to 1 mg/m². Grade 2 w/ pain or grade 3 peripheral neuropathy Reinitiate at 0.7 mg/m² once wkly when toxicity resolves.

Hypersensitivity to bortezomib, boron or mannitol.

Monitor patients for symptoms of neuropathy eg, burning sensation, hyperesthesia, hypoesthesia, paresthesia, discomfort, neuropathic pain or weakness. Patients w/ history of syncope; receiving medications associated w/ hypotension; dehydrated. Acute development or exacerbation of CHF & new onset of decreased left ventricular ejection fraction. Closely monitor patients w/ risk factors for, or existing heart disease. Reports of hepatic events eg, acute liver failure, increased liver enzymes, hyperbilirubinemia, & hepatitis; acute diffuse infiltrative pulmonary disease of unknown etiology eg, pneumonitis, interstitial pneumonia, lung infiltration, & acute resp distress syndrome. Frequently monitor CBCs throughout treatment. Platelet counts should be monitored prior to each dose due to association w/ thrombocytopenia. Reports of GI & intracerebral hemorrhage; transfusion may be considered. May cause nausea, diarrhea, constipation & vomiting; administer fluid & electrolyte replacement to prevent dehydration. Closely monitor patients w/ high tumor burden prior to treatment due to risk of tumor lysis syndrome. May cause tiredness, dizziness, fainting, or blurred vision; do not drive or operate machinery. Closely monitor for toxicities in patients w/ renal impairment (CrCl <13 mL/min) & on hemodialysis; hepatic impairment. Women of childbearing potential should use effective contraceptive measures. Avoid being pregnant & breastfeeding during treatment. Childn.

Thrombocytopenia, neutropenia, anaemia, leucopenia, lymphopenia, pancytopenia, febrile neutropenia, disseminated intravascular coagulation; cardiac disorders; hearing impairment, bilateral deafness; blurred vision, conjunctival infection & irritation, ophth herpes; GI disorders; asthenic conditions, weakness, fatigue, pyrexia, rigors, lower limb edema, lethargy, malaise, neuralgia, chest pain, inj site pain & irritation, inj site phlebitis; hyperbilirubinemia, abnormal LFTs, hepatitis; drug hypersensitivity; infections & infestations; catheter-related complication; increased ALT, AST, alkaline phosphatase, GGT; decreased appetite & anorexia, dehydration, hyperglycemia, hypoglycemia, hyponatremia; limb pain, myalgia, arthralgia; tumor lysis syndrome; nervous system disorders; anxiety; renal impairment & failure, difficulty in micturition, hematuria; epistaxis, cough, dyspnea, exertional dyspnea, pleural effusion, rhinorrhea, hemoptysis, acute diffuse infiltrative pulmonary disease, pulmonary HTN; skin rash, urticaria; hypotension, orthostatic/postural hypotension, petechiae, cerebral hemorrhage.

May inhibit the activity & increase exposure to CYP2C19 substrates. Closely monitor patients for either toxicities or reduced efficacy w/ concomitant use of CYP3A4 inhibitors/inducers. Closely monitor blood glucose levels of patients on concomitant oral antidiabetics. Caution w/ concomitant use of medications that may be associated w/ peripheral neuropathy (eg, amiodarone, antivirals, INH, nitrofurantoin, or statins), or w/ decrease in BP.

Targeted Cancer Therapy

L01XG01 - bortezomib ; Belongs to the class of proteasome inhibitors. Used in the treatment of cancer.

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