IV/SC May be administered as IV (at 1 mg/mL conc) as a 3-5 second inj or SC (at 2.5 mg/mL conc).
Monotherapy: Relapsed multiple myeloma & mantle cell lymphoma 1.3 mg/m
2/dose twice wkly for 2 wk (days 1, 4, 8 & 11) followed by a 10-day rest period (days 12-21).
Extended therapy >8 cycles As per standard schedule or for relapse multiple myeloma, on a maintenance sched of once wkly for 4 wk (days 1, 8, 15 & 22) followed by a 13-day rest period (days 23-35). At least 72 hr should elapse between consecutive doses.
Bortezomib-related neuropathic pain &/or peripheral sensory or motor neuropathy Re-initiate treatment w/ 25% reduced dose (1.3 mg/m
2/dose reduced to 1 mg/m
2/dose; 1 mg/m
2/dose reduced to 0.7 mg/m
2/dose) once symptoms of toxicity are resolved.
Combination therapy: Previously untreated multiple myeloma In combination w/ oral melphalan & prednisone for nine 6-wk treatment cycles. Cycles 1-4: Administer twice wkly (days 1, 4, 8, 11, 22, 25, 29 & 32). Cycles 5-9: Administer once wkly (days 1, 8, 22 & 29). At least 72 hr should elapse between consecutive doses.
Previously untreated mantle cell lymphoma not eligible for haematopoietic stem cell transplantation Administer 6 cycles (see Monotherapy for bortezomib dosage). For patients w/ response 1st documented at cycle 6, 2 additional cycles are recommended. Administer on day 1 of each bortezomib 3-wk treatment cycle as IV infusions: Rituximab 375 mg/m
2, cyclophosphamide 750 mg/m
2 & doxorubicin 50 mg/m
2. Administer oral prednisone 100 mg/m
2 on days 1, 2, 3, 4 & 5 of each treatment cycle.
Moderate to severe hepatic impairment (>1.5x ULN) Reduce to 0.7 mg/m
2 in the 1st cycle. Consider escalation to 1 mg/m
2 or further reduction to 0.5 mg/m
2 in subsequent cycles based on tolerability.