Bortezomib
Aliases: Velcade
Last verified: 2026-09-23
The short version
A dipeptidyl boronate — the first proteasome inhibitor; backbone of multiple-myeloma therapy.
Identity & type
- Molecular type
- peptide
- Origin
- A dipeptidyl boronate — the first proteasome inhibitor; backbone of multiple-myeloma therapy.
Mechanism of action
Reversible 26S proteasome inhibition (chymotrypsin site) → accumulation of pro-apoptotic proteins in myeloma cells.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. 1.3 mg/m² SC/IV per cycle schedule.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
1.3 mg/m² SC/IV per cycle schedule. Velcade: extends survival in myeloma; patients often describe peripheral neuropathy (tingling hands/feet).
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
Velcade: extends survival in myeloma; patients often describe peripheral neuropathy (tingling hands/feet).
Protocol — official vs community
Official / label
Velcade (multiple myeloma, mantle cell lymphoma): 1.3 mg/m² SC or IV on days 1, 4, 8, 11 of a 21-day cycle; combination regimens (e.g. with lenalidomide-dexamethasone) use weekly schedules (days 1, 8, 15 of 28-day cycles).
- 01For grade ≥2 peripheral neuropathy or hematologic toxicity: hold, then resume at a reduced step (1.3 → 1 → 0.7 mg/m² per label tables)
Duration: Induction of 4–8 cycles; continued (often with maintenance) until progression in relapsed disease.
Peripheral neuropathy is the signature dose-limiting toxicity and the reason SC administration is preferred (less neuropathy at equal efficacy). Herpes zoster prophylaxis is standard alongside therapy.
Community (anecdotal)
Structured protocol data for this entry is coming.
Human evidence
Approved 2003; transformed myeloma prognosis.
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Peripheral neuropathy, thrombocytopenia, herpes zoster.characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials