Side effects of bortezomib

The following side effects are common (occurring in greater than 30%) for patients taking Velcade/ Bortezomib:

• Fatigue, generalized weakness
• Peripheral neuropathy: characterized by decreased sensation and paresthesia (numbness and tingling of the hands and feet). There may be worsening of preexisting neuropathy. Your doctor may need to change your dose or schedule of Velcade. Symptoms may improve or return to baseline in some patients once Velcade is discontinued.
• Nausea and vomiting
• Diarrhea
• Poor appetite
• Constipation
• Low platelet count. This can put you at increased risk for bleeding. Nadir: 11 days
• Fever
• Low red blood cell count (Anemia)
  These side effects are less common side effects (occurring in about 10-29%) of patients receiving Velcade:
  • Headache
  • Difficulty sleeping (Insomnia)
  • Joint pains, arthralgia, myalgias
  • Swelling of the face, hands, feet or legs (edema).
  • Low white blood cell count. (This can put you at increased risk for infection.)
  • Shortness of breath
  • Dizziness
  • Rash (see skin reactions)
  • Dehydration
  • Upper respiratory tract infection
  • Cough
  • Bone pain
  • Anxiety
  • Muscle cramps
  • Heartburn
  • Abdominal pain
  • Low blood pressure
  • Itching
  • Blurring of vision
  • Blood test abnormalities: (low sodium, low magnesium, low calcium, low potassium).

We found that the average duration of the response appears to be one year, but this is in the advanced setting, where patients appear to have resistant myeloma. Now Velcade, just like thalidomide, is being brought forward to frontline treatment. It's still in clinical trials, and we will wait to see what sort of a response we get. Of course, we expect that it will be slightly better than it was [in the trial of patients with resistant myeloma], and maybe the responses will last even longer.