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Multiple myeloma refers to the neoplastic proliferation of plasma cells that produces a monoclonal immunoglobin. The proliferation of plasma cells in bone marrow results in extensive skeletal destruction of various bone cells. Most patients are presented with one of the following symptoms: presence of monoclonal protein in urine or serum, systemic signs or symptoms suggestive of malignancy, hypercalcemia and acute renal failure.

Bortezomib is a proteasome inhibitor indicated for multiple myeloma. It exerts its action by inhibiting proteasomes, an enzyme responsible for regulating protein homeostasis within the cell. Bortezomib has been proven effective in prolonging the overall survival in several trials. Studies have shown that 87% of patients survive after 12 months. Although a small proportion of patients experience neuropathy, the neuropathic pain disappear within a median of 3 months of stopping bortezomib. In general, bortezomib is useful in maximizing patient’s benefit with manageable toxicity.