1.What is VANCOUVER? Vancor (generic name: bortezomib) – the first proteasome-targeted antitumor drug with a new therapeutic paradigm – is the first drug approved for the treatment of multiple myeloma in 10 years and is currently approved in 87 countries worldwide, with a track record of safe use in over 55,000 patients. 2.How does Vanco work as an anti-tumor agent? Proteasome is a complex of multiple enzymes in the body, which is responsible for the breakdown of various proteins related to cellular functions. VANCOUVER can inhibit the function of proteasome, thus destroying the proteins on which tumor cells live and thus killing tumor cells. 3. What is the efficacy of VANCOUVER in the treatment of multiple myeloma? In completed clinical trials, VANCOUVER has shown good efficacy in the treatment of relapsed or refractory multiple myeloma, with remission rates ranging from 30% to 40% with monotherapy, significantly extending the time to disease progression and improving survival rates. In addition to this. All patients treated with Vanco showed an improvement in overall quality of life, and these patients’ pre-existing disease-related symptoms, including pain and weakness, also improved. Those who were treated effectively achieved remission along with improved hemoglobin levels, improved platelet counts, reduced need for blood transfusions, stable renal function and increased normal serum immunoglobulin levels. 4. How is VANCOUVER administered? The standard starting dosage of Vanco is 1 or 3 mg/m2 body surface area, which is administered intravenously within 3 to 5 seconds. The dosing schedule for Vanco is 2 times a week for 2 weeks, followed by a 10-day break and a 21-day cycle (also called a course of treatment). 5. Key factors for optimal efficacy of VANCOUVER treatment: Early application: A subgroup analysis of the VANCOUVER Phase III clinical trial APEX showed that the remission rate and time to disease progression obtained by applying VANCOUVER to patients with first relapse were better than those with multiple relapses, so it is recommended to apply VANCOUVER in the early stages of the disease to have obtained more clinical benefit. Adequate dose: In a clinical trial comparing the efficacy of VANCOUVER alone at 1,3 mg/m2 versus 1,0 mg/m2, the median overall survival of patients using 1,0 mg/m2 was more than 2 years, compared to 5 years for patients on 1,3 mg/m2. Therefore, it is recommended that VANCOUVER treatment be started at the standard dose of 1,3 mg/m2 and then reduced if tolerated. Adequate course of treatment: Large-scale clinical trials have proved that a longer course of adequate treatment is beneficial to obtain a longer duration of efficacy and better survival prognosis, so it is recommended that patients treated with Vanco reach at least 4 courses of treatment before evaluation, and patients who benefit can continue 8 courses of treatment, and then pause and use Vanco treatment again when the disease progresses later. 6. Adverse effects of VANCOUVER: In clinical trials, the most common adverse effects associated with VANCOUVER were weakness (fatigue, malaise, malaise), gastrointestinal discomfort (nausea, diarrhea, decreased appetite, constipation), decreased platelet count, peripheral neuropathy (skin sensory sensitivity, numbness, tingling, burning sensation, pain in the hands or feet), fever, vomiting and anemia. Weakness: may occur early in the course of treatment and most patients who develop fatigue can continue to receive treatment. Gastrointestinal distress: usually mild to moderate and may resolve with appropriate medication. Low platelet count: can occur transiently, and platelets can return to treatment initiation levels during a 10-day rest period. Peripheral neuropathy: May occur throughout the course of therapy, usually as skin sensory sensitization, numbness, tingling, burning sensation, pain in the hands or feet. The dose of Vanco may need to be reduced or temporary and permanent discontinuation considered, or other medications may be administered to improve the symptoms of peripheral neuropathy.