Multiple myeloma is a type of cancer prevalent in many parts of the world. This condition affects the plasma cells in bone marrow and is common among male adults over 60. It could be fatal if left untreated.
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The bone marrow is the body part responsible for producing different blood cells. When it gets affected by cancer, the abnormal cells that are produced spread to other parts of the body; hence the term “multiple” myeloma.
Although multiple myeloma is a life-threatening disease, studies have revealed the efficacy of a medication to contain its symptoms and help patients live more comfortably. In this article, we will review this medication, Velcade (bortezomib), its treatment, administration, dosage, side effects, and possible cost.
What Is Velcade?
Velcade is an anti-cancer drug used to treat cancer conditions such as multiple myeloma and mantle cell lymphoma. It is usually administered to people whose conditions have not improved after different treatment therapies. The drug works by killing cancer cells.
It was first made in 1995 at Myogenics and was known as PS-341. To prove its efficacy, it was tested in a small Phase 1 clinical trial on patients with multiple myeloma in the same year. With positive results, it was brought out for further clinical trials by Millenium Pharmaceuticals in 1999.
However, it was not until 2003, 8 years after its synthesis, that it got the Food and Drug Administration’s approval in the United States as a treatment option for refractory multiple myeloma. In 2005, bortezomib was also approved by the FDA as a treatment option for people with multiple myeloma who had received at least one previous therapy, and in 2008, it was approved as an initial treatment for patients with multiple myeloma.
Finally, it was approved for the retreatment of multiple myeloma patients in August 2014 and the treatment of mantle cell lymphoma in October 2014. Bortezomib can be taken on its own or with other cancer drugs such as melphalan, liposomal doxorubicin, panobinostat, and thalidomide. It can also be taken with steroids such as prednisolone.
What Is Velcade Used For?
Bortezomib is used to treat multiple myeloma and mantle cell lymphoma. Both of these conditions are types of cancer, and the drug works by killing off the cancer cells and putting the condition into remission. However, keep in mind that the drug does not cure any of these conditions, as it only treats and helps put them into remission.
How Does It Work?
Bortezomib belongs to a class of cancer drugs known as proteasome inhibitors. It restricts and prevents the growth of proteasomes in human cells.
Proteasomes exist in the cells, and their major function is to break down the protein the cell does not need. Thus, when you use proteasome inhibitors, it prevents the proteasomes from performing their function, and protein builds up in the cells, causing the cells to die.
In patients with multiple myeloma and mantle cell lymphoma, bortezomib targets the cancer cells because cancer cells are more sensitive to the effects of bortezomib. It prevents the proteasomes in these cells from performing their functions, leading to the death of the cancer cells.
Drug Administration
Bortezomib is usually administered under the skin (subcutaneously) or into the bloodstream (intravenously). Subcutaneously, you can get the injection in your thigh or abdomen. Regardless of where you are getting the injection, you should change the injection site every time you get the injection to reduce pain and injury to the skin.
The drug is administered twice weekly for two weeks. After two weeks, there is a 13-day rest period, completing the three weeks of the cycle. You will have this treatment cycle for a maximum of 8 cycles.
If the levels of Serum M (a type of protein made by myeloma cells) in your body have been reduced, the treatment is working, and you will complete two more treatment cycles. You will continue eight more treatment cycles if the levels have not reduced significantly. However, cycles may vary for patients depending on the severity of their condition. Hence, your doctor will determine what is most suitable for you.
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Velcade Side Effects
Some side effects associated with using bortezomib include:
- Weakness
- Constipation
- Nausea
- Dizziness
- Vomiting
- Loss of appetite
- Pain
- Headache
In extreme cases, nausea, diarrhea, and vomiting may get severe. You should contact your pharmacist or doctor whenever you experience severe side effects.
Another peculiar side effect you may experience after using the drug is tumor lysis syndrome. This side effect occurs due to the rapid destruction of cancer cells. To reduce the risk of this side effect, it’s advisable you drink lots of water and take additional recommended medications as directed.
Anemia is another side effect that you might experience with bortezomib. This is because the medication might decrease the number of red blood cells in the body. This side effect results in the body feeling tired and weak.
Finally, a rash is another side effect that comes with the use of this medication. However, the rash should not be serious and should go away quickly. Developing severe allergic reactions to bortezomib is rare and was not reported in the clinical studies carried out to test the efficacy of the medication. Thus, if you experience any severe allergic reaction, you should immediately contact your doctor or pharmacist.
Cost
The average retail price for bortezomib is about $1,644 for one powder of intravenous injection. However, there are many factors that can affect the exact price you pay, such as your location, insurance, and healthcare plan.
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Miralle Kaldass was born and raised in Egypt. She received her pharmacy degree from the Faculty of Pharmacy, Cairo University, and has 5 years of experience as a pharmacist. The most rewarding part of her job is providing patient care where a patient’s health can improve and allow them to live a better life. Her areas of expertise include long-term care with nursing homes and hospices, specialty pharmacy, and TPN. In her free time, she enjoys going to the gym, shopping, and walking by the beach.