Bortezomib was not associated with cardiac events among patients with previously untreated or relapsed/refractory multiple myeloma (MM), according to a study published in the British Journal of Haematology.1

Proteasome inhibitors were previously associated with cardiac events and warnings of cardiac toxicity. The purpose of this retrospective study was to assess the cardiac toxicity profile of bortezomib.

This retrospective analysis was of pooled data from 1 phase 2 and 7 phase 3 studies of patients with previously untreated and relapsed/refractory MM and included 2509 patients treated with bortezomib and 1445 patients who received non-bortezomib treatment.

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The median age range in the studies was 57 to 71, and cardiac history was present in 21% to 74% of patients.

There was no significant difference of grade 3 or worse congestive heart failure (CHF) between the bortezomib-treated and non-bortezomib treated arms.

The incidences of arrhythmias (grade 2 or worse, 1.3% to 5.9%), ischemic heart disease (all grades, 1.2% to 2.9%), and cardiac death (0% to 1.4%) were also similar between bortezomib and non-bortezomib–treated groups.

There was no effect of bortezomib treatment on cardiac risk compared with no bortezomib treatment as determined by logistic regression analysis of the comparative studies.

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These data suggest that bortezomib may not cause cardiac toxicity.

The authors wrote that a better understanding of underlying mechanisms is needed and “data from ongoing prospective and comparative studies are necessary to determine whether proteosome inhibitors have different cardiotoxicity profiles.”


  1. Laubach JP, Moslehi JJ, Francis SA, et al. A retrospective analysis of 3954 patients in phase 2/3 trials of bortezomib for the treatment of multiple myeloma: towards providing a benchmark for the cardiac safety profile of proteosome inhibition in multiple myeloma. Br J Haematol. 2017 May 5. doi: 10.1111/bjh.14708 [Epub ahead of print]