From the FDA Drug Label
Bortezomib for injection retreatment may be considered for patients with multiple myeloma who had previously responded to treatment with bortezomib and who have relapsed at least six months after completing prior bortezomib treatment.
- Retreatment with bortezomib can be started at least 6 months after the last dose of prior bortezomib treatment, in patients who have relapsed and previously responded to bortezomib treatment 1.
- The last tolerated dose can be used when restarting bortezomib treatment 1.
- There is no direct information in the provided drug labels regarding the specific timing of restarting bortezomib after surgery.
- However, based on the available information, bortezomib retreatment can be considered in patients who have relapsed at least 6 months after completing prior bortezomib treatment, and the decision to restart treatment after surgery should be made on a case-by-case basis, taking into account the patient's overall clinical condition and the potential risks and benefits of retreatment 1.
From the Research
Velcade can typically be restarted 2-4 weeks after surgery, depending on the extent of the procedure and how well the surgical wound is healing, as supported by recent studies on proteasome inhibitors in multiple myeloma treatment 2, 3. The decision to restart Velcade should always be made by your oncologist in consultation with your surgeon, taking into account the individual patient's recovery status and underlying condition. Key factors to consider include:
- The extent of the surgical procedure
- The rate of wound healing
- The patient's overall recovery status
- Blood counts and kidney function
- The urgency of continuing cancer treatment For minor surgeries with good healing, Velcade might be resumed as early as 14 days post-operation, while major surgeries may require waiting 3-4 weeks or longer. Complete wound healing is essential before restarting Velcade because the medication can impair wound healing and increase infection risk by suppressing the immune system, as noted in studies on the use of proteasome inhibitors in multiple myeloma treatment 4, 5. Your doctor will assess your surgical site, overall recovery status, blood counts, and kidney function before giving clearance to resume treatment. If you experience any signs of poor wound healing, infection, or other complications, Velcade restart may need to be delayed further, highlighting the importance of careful management and monitoring in the use of proteasome inhibitors 6.