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IWWM-12 2024 | Managing AEs associated with bortezomib in the treatment of Waldenström’s macroglobulinemia
Jahanzaib Khwaja, MD, FRCPath, University College London Hospitals NHS Foundation Trust, London, UK, discusses adverse events (AEs) associated with bortezomib in the treatment of Waldenström’s macroglobulinemia, with reference to his study of bortezomib in patients who have failed BTK inhibitors. He mentions neurotoxicity and cytopenias as potential AEs that can be managed with dose reductions and close monitoring. This interview took place at the 12th International Workshop on Waldenström’s Macroglobulinemia (IWWM-12) in Prague, Czech Republic.
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Transcript
Traditionally, there have been concerns with bortezomib about neuropathy and neurotoxicity, and that’s particularly been the case when considered twice a week, intravenous injections, and we’ve seen with more recent administrations subcutaneously and given weekly or every two weeks that these side effects can be really manageable. We know that you can select patients more carefully, so those with pre-existing neuropathy, you may want to dose-reduce the therapy or you may want to just closely monitor these patients...
Traditionally, there have been concerns with bortezomib about neuropathy and neurotoxicity, and that’s particularly been the case when considered twice a week, intravenous injections, and we’ve seen with more recent administrations subcutaneously and given weekly or every two weeks that these side effects can be really manageable. We know that you can select patients more carefully, so those with pre-existing neuropathy, you may want to dose-reduce the therapy or you may want to just closely monitor these patients. And we’ve seen in the 16 patients all the neuropathy cases were grade one or two and there’s no one with grade three or four. Other side effects are quite tolerable, I think, so cytopenias, so neutropenia or thrombocytopenia can be monitored and managed and we didn’t have any major signals of any other significant toxicities including infection and certainly in this 16 patient series there were no cessations due to toxicity of bortezomib.
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