Bortezest is an antineoplastic (anti-cancer) medication that belongs to the class of proteasome inhibitors. It is primarily used for the treatment of multiple myeloma and mantle cell lymphoma. By disrupting cellular processes, it helps to prevent cancer cells from growing and multiplying.

Uses

Multiple Myeloma: Bortezest is often used as a first-line treatment in combination with other drugs such as dexamethasone or lenalidomide.

Mantle Cell Lymphoma (MCL): It is approved for the treatment of MCL in patients who have received at least one prior therapy.

Bortezest inhibits the 26S proteasome, a protein complex involved in breaking down unneeded or damaged proteins. By inhibiting the proteasome, Bortezest induces apoptosis (programmed cell death) in cancer cells, disrupting their survival mechanisms.

Side Effects

Common side effects: Fatigue, Nausea and vomiting, Peripheral neuropathy, Diarrhea or constipation, Low blood cell counts (anemia, leukopenia and thrombocytopenia)

Serious side effects: Severe neuropathy, Cardiac complications, Liver dysfunction, pulmonary issues

Precautions

1. Infections: Bortezest may suppress the immune system, increasing the risk of infections.

2. Liver and Kidney Function: Use cautiously in patients with impaired liver or kidney function.

3. Pregnancy and Lactation: Bortezest can cause harm to the fetus and should not be used during pregnancy. Breastfeeding is also not recommended during treatment.

4. Peripheral Neuropathy: Monitor for symptoms like tingling, numbness, or pain in extremities.

Drug Interactions

• Medications: May interact with drugs like CYP3A4 inhibitors (e.g., ketoconazole) and inducers (e.g., rifampin).

• Herbal Products: Avoid St. John’s Wort as it may reduce Bortezest's effectiveness.

Dosage and Administration

• Formulation: Bortezest is available as an injectable solution.

• Route of Administration: It can be given intravenously (IV) or subcutaneously (SC).

• Dosage: The typical dose is 1.3 mg/m² body surface area, administered twice weekly for two weeks, followed by a 10-day rest period. Dosage and duration may vary based on the condition being treated and patient response.

Storage and Handling

• Store Bortezest vials at controlled room temperature.

• Reconstituted solutions should be used promptly or stored as per manufacturer instructions.