Assessing the Side-Effects of Bortezomib Using LC-MS

Cancer is a devastating disease that can affect people of all ages at any time. In the UK alone there are over 350,000 new cases of cancer each year, every two minutes someone is diagnosed with cancer. Over 50% of new cancer diagnosis are either breast, prostate, lung or bowel cancers - but there are many types of cancer that can affect people.

Myeloma is one such cancer with 16 new cases every day in the UK - that is about 2% of new cases. There are many different treatments for cancer depending on the type of cancer and what stage the cancer is at. But cancer treatments are not kind to the body - they can potentially affect healthy cells along with the cancer cells. Chromatography has recently been used to assess the toxicity of bortezomib to the central nervous system.

Myeloma and bortezomib

Myeloma is the nineteenth most common cancer in the UK and incidence rates are increasing since the early 1990s and are expected to carry on increasing for the foreseeable future. There are around 3000s myeloma deaths each year in the UK - but deaths due to myeloma are hopefully going to fall over the next few years as detection and treatments have improved.

Myeloma is a type of bone marrow cancer. Our bone marrow lies at the centre of our bones and produces our blood cells. It is sometimes known as multiple myeloma as the cancer can sometimes affect different areas of the body at the same time. Unlike other cancers, myeloma doesn’t always produce a tumour, but it can damage the bones and disrupt the production of new blood cells.

Bortezomib is a proteasome inhibitor, a type of drug used to treat cancer. It works by stopping proteasomes from working. These are large molecules that are found in cells. They break down damaged and unwanted proteins that are found in cells. Bortezomib stops the proteasomes from breaking down unwanted proteins, as the proteins build up inside the cells, they reach toxic levels and the cells dies. The myeloma cells rely on the proteasomes more than healthy cells meaning that the myeloma cells are more sensitive to bortezomib

Chromatography analyses bortezomib

Unfortunately, cancer treatments can potentially damage healthy cells and organs. A recent paper published in Brain Communications reports on a trial carried out to assess the toxicity of the drug towards the central nervous system (CNS). The team used liquid chromatography-mass spectrometry to analyse bortezomib concentration in brain tissue in patients and mice after injection with the drug.

The use of chromatography to analyse mouse serum samples is discussed in the article, Fenfluramine and Norfenfluramine in Mouse Brain and Cerebellum by Liquid Chromatography Tandem Mass Spectrometry using a Novel Solid-Supported Liquid Extraction. The team report that the drug only penetrated the blood brain barrier at low concentrations and so is unlikely to be toxic to the CNS.