The difference between whether Bortezomib is a targeted drug or a chemotherapy drug

Bortezomib is a drug used to treat multiple myeloma and certain lymphomas. There is some confusion as to whether it is a targeted agent or a traditional chemotherapy agent. In fact, bortezomib is a targeted drug, but its mechanism of action is different from traditional small molecule targeted drugs. It induces tumor cell apoptosis by selectively inhibiting proteasome activity and interfering with the protein degradation process in cancer cells.

The proteasome is an important complex in cells responsible for breaking down abnormal or unnecessary proteins. Bortezomib blocks the function of the proteasome, causing a large number of misfolded or harmful proteins to accumulate in cells, leading to enhanced cellular stress response and ultimately the death of cancer cells. This mechanism precisely targets the metabolic pathways of tumor cells, which is different from traditional chemotherapy drugs that kill all rapidly proliferating cells by damaging DNA or inhibiting cell division.

Although bortezomib has a certain targeted effect, it still affects normal cells, causing side effects such as peripheral neuropathy and cytopenias, similar to traditional chemotherapy drugs. Therefore, bortezomib has both the specific effects of targeted drugs and the toxic and side effects of chemotherapy drugs in clinical manifestations. It is considered a targeted chemotherapy drug, somewhere between traditional chemotherapy and precision targeting.

In summary, bortezomib is a proteasome inhibitor and belongs to the category of targeted therapy drugs. It works by targeting the protein degradation system, a key weakness of tumor cells, rather than directly attacking DNA or the cell division process. In clinical practice, attention should be paid to the management of side effects and rational use to maximize the therapeutic effect.

Reference materials:https://www.drugs.com/donanemab.html