General aspects and mechanisms of peripheral neuropathy associated with bortezomib in patients with newly diagnosed multiple myeloma

Semin Hematol. 2012 Jul;49(3):249-57. doi: 10.1053/j.seminhematol.2012.04.001.


Introduction of the proteasome inhibitor bortezomib (Velcade, Millennium Pharmaceuticals, The Takeda Oncology Company, Cambridge, MA) has substantially improved outcomes for patients with multiple myeloma (MM), and has become one of the cornerstones of current anti-myeloma treatment regimens. However, with the introduction of bortezomib it has become clear that peripheral neuropathy (PN) is one of the most frequent, potentially disabling, nonhematologic complications of bortezomib, often requiring dose modification or discontinuation, with a potential negative impact on clinical endpoints and quality of life. To find a balance between maximal benefit of bortezomib treatment, while maintaining quality of life, it is necessary to minimize toxicity. Here, we discuss all aspects of bortezomib-induced peripheral neuropathy (BiPN), and elaborate on the mechanisms underlying the development of BiPN.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Boronic Acids / administration & dosage
  • Boronic Acids / adverse effects*
  • Boronic Acids / therapeutic use*
  • Bortezomib
  • Humans
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / enzymology
  • Peripheral Nervous System Diseases / chemically induced*
  • Proteasome Endopeptidase Complex / metabolism
  • Proteasome Inhibitors / administration & dosage
  • Proteasome Inhibitors / adverse effects*
  • Proteasome Inhibitors / therapeutic use*
  • Pyrazines / administration & dosage
  • Pyrazines / adverse effects*
  • Pyrazines / therapeutic use*
  • Quality of Life


  • Boronic Acids
  • Proteasome Inhibitors
  • Pyrazines
  • Bortezomib
  • Proteasome Endopeptidase Complex