Bortezomib and Waldenstrom's macroglobulinemia.

Abstract

Despite advances in therapy, Waldenstrom's macroglobulinemia (WM) remains incurable. Guidelines on therapeutic alternatives in WM recommended the use of alkylating agents, rituximab, nucleoside analogues and anthracyclins either in first line or at relapse and in combination in fit patients. While the overall response rates of combination regimens reached up to 80 - 90% in some studies, the complete response rate is low, no greater than 10 - 20%; and the disease-related median survival for symptomatic patients is approximately 6 years. As such, new therapeutic agents are needed for the treatment of WM. In ongoing efforts, advances were made in the understanding of the biology of WM so as to better target therapeutics for this malignancy. Several preclinical studies have demonstrated that the NFkappaB pathway is a potential target for therapeutics in WM. Bortezomib (Velcade) is the first approved proteasome inhibitor for treating relapse/refractory multiple myeloma and, among other mechanisms of action, significantly inhibits the NFkB pathway. This report provides an update on biological studies and clinical efforts to develop bortezomib as a new treatment of Waldenstrom's macroglobulinemia.

• Authors: Laurent Pascal, Julie Gay, Christophe Willekens, Mathieu Wemeau, Sandy Balkaran, Daniela Robu, Aldo Roccaro, Pierre Morel, Irene Ghobrial, Xavier Leleu
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 10 Issue 5 Pg. 909-16 (Apr 2009) ISSN: 1744-7666 [Electronic] England
• PMID: 19351237 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Boronic Acids
• Pyrazines
• Bortezomib

Topics

• Animals
• Boronic Acids (chemistry, therapeutic use)
• Bortezomib
• Clinical Trials as Topic (methods, trends)
• Humans
• Pyrazines (chemistry, therapeutic use)
• Waldenstrom Macroglobulinemia (drug therapy, physiopathology)