Clinical challenges associated with bortezomib therapy in multiple myeloma and Waldenströms Macroglobulinemia

Leuk Lymphoma. 2009 May;50(5):694-702. doi: 10.1080/10428190902866732.


Rapid development of the small molecule proteasome inhibitor bortezomib has yielded important clinical benefit for patients with multiple myeloma. Early phase clinical trials suggest the agent has similar efficacy in Waldenströms Macroglobulinemia. Optimization of bortezomib-based therapy, though, requires an understanding of the various challenges associated with use of the drug. This review highlights the rationale for bortezomib therapy in patients with multiple myeloma and Waldenströms Macroglobulinemia, mechanisms of bortezomib resistance, important therapy-related side effects, and new directions for the use of proteasome inhibitors in these disorders.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Boronic Acids / adverse effects
  • Boronic Acids / therapeutic use*
  • Bortezomib
  • Drug Resistance, Neoplasm
  • Humans
  • Multiple Myeloma / drug therapy*
  • Protease Inhibitors / therapeutic use
  • Pyrazines / adverse effects
  • Pyrazines / therapeutic use*
  • Waldenstrom Macroglobulinemia / drug therapy*


  • Antineoplastic Agents
  • Boronic Acids
  • Protease Inhibitors
  • Pyrazines
  • Bortezomib