Proteasome inhibitor
26S proteasome inhibitor
- Misfolded proteins accumulate
- Antibody-secreting myeloma cells are especially vulnerable → apoptosis
- Peripheral neuropathy is the signature toxicity
- Peripheral neuropathy is dose-limiting
- Herpes zoster reactivation → antiviral prophylaxis
Drugs with this mechanism (1)
- Bortezomib — Proteasome inhibitor; give subcutaneously to spare the nerves.
Self-check
- Which antibody-secreting cells are especially vulnerable to proteasome inhibition?
Myeloma cells. - Why is antiviral prophylaxis used with proteasome inhibition?
Herpes zoster reactivation.
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