Proteasome inhibitors block the breakdown of protein within myeloma cells, causing them to stop growing and die.
The most commonly used proteasome inhibitors for myeloma are bortezomib and carfilzomib, but new types are emerging.
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How they are given
Bortezomib is given as an injection under the skin or into a vein. It is often used together with steroids and chemotherapy.
Carfilzomib is given intravenously.
Side effects
Bortezomib and carfilzomib may cause fatigue, diarrhoea, nausea, low blood counts, shingles and peripheral neuropathy.
Carfilzomib may cause heart problems or worsen pre-existing conditions. Most side effects can be managed.
Dr Jane Estell, Senior Staff Specialist, Haematology Department, Concord Cancer Centre, and Senior Clinical Lecturer, The University of Sydney; Brenda Clasquin, 13 11 20 Consultant, Cancer Council NSW; Jacqui Keogh, Senior Myeloma Support Nurse, Myeloma Australia; Dr Silvia Ling, Haematologist, Liverpool Hospital and Sydney Adventist Hospital; and John Miller, Consumer.
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