title: Bortezomib-induced paralytic ileus is a potential gastrointestinal side effect of this first-in-class anticancer proteasome inhibitor.
abstract: Bortezomib is the first anticancer proteasome inhibitor introduced into clinical practice. It has been recently approved for the treatment of multiple myeloma, an incurable plasma cell tumour that accounts for 10-15% of all haematologic malignancies and for approximately 20% of deaths. Gastrointestinal toxicity associated with the use of this drug is common but generally mild to moderate. Paralytic ileus in patients undergoing bortezomib treatment has been reported, although a definite attribution to bortezomib administration has not been established. We report a myeloma patient who developed severe paralytic ileus during bortezomib therapy, which presented in the context of progressive constipation without other known causes and which regressed promptly with medical management after drug cessation, suggesting a direct causal relationship. Awareness of the various potential gastrointestinal toxic effects of bortezomib is of relevance given the growing number of patients undergoing treatment with this important and effective new cancer drug.
authors.affiliation: Internal Medicine I, IRCCS Policlinico S. Matteo-Università di Pavia, Pavia, Italy. v.perfetti@smatteo.pv.it
authors.forename: Vittorio
authors.initials: V
authors.lastname: Perfetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palladini
authors.forename: Laura
authors.initials: L
authors.lastname: Brunetti
authors.forename: Adele
authors.initials: A
authors.lastname: Sgarella
authors.forename: Silvia
authors.initials: S
authors.lastname: Brugnatelli
authors.forename: Paolo G
authors.initials: PG
authors.lastname: Gobbi
authors.forename: Gino Roberto
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001897:Boronic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D000069286:Bortezomib; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy; D011480:Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011719:Pyrazines / Q000009:adverse effects* / Q000627:therapeutic use; D011859:Radiography
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011480:Protease Inhibitors; D011719:Pyrazines; D000069286:Bortezomib