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Bortezomib: A Review in Mantle Cell Lymphoma in Previously Untreated Patients Unsuitable for Stem-Cell Transplantation

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Abstract

Bortezomib (Velcade®) is a proteasome inhibitor that is approved for the treatment of multiple myeloma and mantle cell lymphoma (MCL). This article reviews the efficacy and tolerability of bortezomib in combination with rituximab, cyclophosphamide, doxorubicin and prednisone (VR-CAP) in the treatment of previously untreated MCL unsuitable for stem-cell transplantation, and overviews the pharmacology of bortezomib. In the large, randomized, assessor-blinded, multinational LYM-3002 trial, induction therapy with VR-CAP improved progression-free survival significantly more than R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) after a median follow-up of 40 months in patients with newly diagnosed MCL ineligible or not considered for stem-cell transplantation. Complete response and certain other secondary endpoints were improved significantly more with VR-CAP than R-CHOP. Overall survival data were not mature at the time of assessment. The improved efficacy with VR-CAP was accompanied by an increased incidence of grade 3 or higher adverse events, particularly haematological adverse events.

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Disclosure

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit. Paul L. McCormack is a salaried employee of Adis/Springer.

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    Paul L. McCormack

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Correspondence to Paul L. McCormack.

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The manuscript was reviewed by: D. Leveque, Department of Pharmacy, Hôpital Hautepierre, Strasbourg, France; B. Metzner, Department of Oncology and Hematology, Klinikum Oldenburg, University Clinic, Oldenburg, Germany; T. Robak, Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland; S. Rule, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.

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McCormack, P.L. Bortezomib: A Review in Mantle Cell Lymphoma in Previously Untreated Patients Unsuitable for Stem-Cell Transplantation. BioDrugs 29, 207–214 (2015). https://doi.org/10.1007/s40259-015-0131-8

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