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.
What is Bortezomib (Velcade)?:
Bortezomib is a drug that belongs to the class of drugs called proteasome inhibitors. 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.
How does Bortezomib (Velcade) act in Lymphomas?:
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.
How effective is Velcade in Mantle Cell Lymphoma?:
Mantle Cell Lymphoma is an aggressive lymphoma that has a poor outcome, especially when first-line treatment has failed. The PINNACLE trial, that published its results in October 2006, used Velcade in patients with Mantle Cell Lymphoma who had failed after at least one prior treatment. There was a substantial response in 31% of the patients, and progression was delayed by more than 6 months in more than half the patients. In view of the otherwise poor outlook in Mantle Cell lymphoma in this setting, these results demonstrate a new treatment which is well worth trying.
How is Velcade administered in Mantle Cell Lymphoma?:
Velcade is administered as a bolus (or one-shot) injection in the veins. It is given twice a week for two weeks (a total of four doses on days 1, 4, 8 and 11) followed by a 10 day gap. This adds up to one cycle of chemotherapy. These cycles are repeated until there is disease progression or there is a need to stop treatment due to side effects.
