IV/SC Administer as 3-5 sec as IV bolus through peripheral or central IV catheter, or SC through the thighs (right or left) or abdomen (right or left).
Progressive multiple myeloma in patients who have received at least 1 prior therapy: Monotherapy 1.3 mg/m
2 twice wkly for 2 wk on days 1, 4, 8, & 11 in 21-day treatment cycle for 2 cycles following confirmation of complete response.
Patient who does not achieve complete remission Total of 8 cycles. At least 72 hr should elapse between consecutive doses.
Combination therapy 1.3 mg/m
2 twice wkly for 2 wk on days 1, 4, 8, & 11 in 21-day treatment cycle. At least 72 hr should elapse between consecutive doses.
Combination w/ pegylated lipos doxorubicin 30 mg/m
2 pegylated lipos doxorubicin on day 4 of treatment cycle as 1 hr IV infusion administered after bortezomib inj. Administer up to 8 cycles as long as patients have not progressed & tolerate treatment. May continue treatment for at least 2 cycles after 1st evidence of complete response, even if this requires treatment for >8 cycles, in patients achieving complete response. Continue for as long as treatment is tolerated & continue to respond in patients whose levels of paraprotein continue to decrease after 8 cycles.
Combination w/ dexamethasone Dexamethasone 20 mg orally on days 1, 2, 4, 5, 8, 9, 11, & 12 of treatment cycle.
Patient achieving response or stable disease after 4 cycles of combination therapy Continue to receive same combination for max of 4 additional cycles.
Previously untreated multiple myeloma patients who are not eligible for haematopoietic stem cell transplantation: Combination w/ melphalan & prednisone 1.3 mg/m
2 twice wkly on days 1, 4, 8, 11, 22, 25, 29 & 32 in cycles 1-4, & once wkly on days 1, 8, 22 & 29 in cycles 5-9. At least 72 hr should elapse between consecutive doses. 6-wk period = treatment cycle. 9 mg/m
2 melphalan & 60 mg/m
2 prednisone orally on days 1, 2, 3 & 4 of 1st wk of each treatment cycle. Administer 9 cycles.
Previously untreated multiple myeloma patients eligible for haematopoietic stem cell transplantation (induction therapy): Combination w/ dexamethasone 1.3 mg/m
2 twice wkly for 2 wk on days 1, 4, 8, & 11 in 21-day treatment cycle. At least 72 hr should elapse between consecutive doses. Dexamethasone 40 mg orally on days 1, 2, 3, 4, 8, 9, 10 & 11 of treatment cycle for 4 cycles.
Combination w/ dexamethasone & thalidomide 1.3 mg/m
2 twice wkly for 2 wk on days 1, 4, 8, & 11 in 28-day treatment cycle. At least 72 hr should elapse between consecutive doses. Dexamethasone 40 mg on days 1, 2, 3, 4, 8, 9, 10 & 11 of treatment cycle. Thalidomide 50 mg orally daily on days 1-14, increase dose to 100 mg on days 15-28 if tolerated, & may be further increased to 200 mg daily from cycle 2 thereafter. Administer 4 cycles of this combination therapy.
Patient w/ at least partial response Give 2 additional cycles.
Previously untreated mantle cell lymphoma: Combination w/ rituximab, cyclophosphamide, doxorubicin & prednisone 1.3 mg/m
2 twice wkly for 2 wk on days 1, 4, 8 & 11 followed by 10-day rest period on days 12-21 for 6 cycles.
Patient w/ response 1st documented at cycle 6 May give 2 additional cycles. Rituximab 375 mg/m
2, cyclophosphamide 750 mg/m
2 & doxorubicin 50 mg/m
2 as IV infusions on day 1 of each 3-wk treatment cycle. Prednisone 100 mg/m
2 orally on days 1, 2, 3, 4 & 5 of each treatment cycle.
Moderate or severe hepatic impairment 0.7 mg/m
2 during 1st treatment cycle, & subsequent dose escalation to 1 mg/m
2 or further dose reduction to 0.5 mg/m
2 based on patient tolerability.
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