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Peripheral neuropathy during bortezomib treatment of multiple myeloma: a review of recent studies

Guido Cavaletti1, Andrzej J Jakubowiak

  • 1Department of Neurosciences and Biomedical Technologies, University of Milan-Bicocca, Monza, Italy. guido.cavaletti@unimib.it

Leukemia & Lymphoma
|May 26, 2010
PubMed

Insights

Peripheral neuropathy (PN) is a common side effect of bortezomib in multiple myeloma (MM) treatment. Managing bortezomib-induced PN (BIPN) involves dose adjustments and exploring new therapies to improve patient quality of life.

Area of Science:

  • Oncology
  • Neurology
  • Pharmacology

Background:

  • Peripheral neuropathy (PN) is a significant dose-limiting toxicity in multiple myeloma (MM) treatment.
  • Bortezomib-induced PN (BIPN) affects a substantial percentage of patients, with cumulative dose being a key predictor.
  • Understanding BIPN is crucial for managing MM patients and maintaining their quality of life.

Purpose of the Study:

  • To review the clinical profile and management guidelines for bortezomib-induced peripheral neuropathy (BIPN) in multiple myeloma (MM).
  • To discuss research exploring novel therapeutic strategies and second-generation proteasome inhibitors for BIPN.
  • To highlight the importance of dose modification and patient quality of life in BIPN management.

Main Methods:

  • Review of clinical trial data and published literature on BIPN in MM.
  • Analysis of treatment-emergent toxicity profiles and dose-limiting factors.
  • Evaluation of emerging research on co-therapies and novel agents for BIPN management.

Main Results:

  • BIPN incidence in MM clinical trials ranges from 37-44%, strongly correlated with cumulative bortezomib dose.
  • Lower BIPN rates are observed in solid tumors compared to hematologic malignancies.
  • Novel agents like tanespimycin and second-generation proteasome inhibitors (carfilzomib, NPI-0052) show potential in reducing BIPN incidence.
  • National Cancer Institute dose-modification guidelines are effective in mitigating BIPN.
  • While BIPN often reverses upon treatment cessation, recovery can be prolonged (up to 1.7 years), with some patients experiencing persistent deficits.

Conclusions:

  • Adherence to dose modification protocols is essential for managing BIPN in MM patients.
  • Emerging therapies offer promising avenues for reducing BIPN incidence and severity.
  • BIPN significantly impacts quality of life due to pain, necessitating continued research into mechanisms and mitigation strategies.

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