Proteasome inhibitors in pediatric cancer treatment.

The 26S proteasome regulates the degradation of many proteins involved in cell cycle control, apoptosis, and tumor growth. The inhibition of the proteasome by specific inhibitors is a viable target for anti-tumor therapy Most prominently, the proteasome inhibitor bortezomib (Velcade) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of relapsed or refractory multiple myeloma in adults, and is presently considered for several other types of cancer including pediatric malignancies. The first clinical trials by the Children's Oncology Group (COG) were conducted with bortezomib for the treatment of refractory solid tumors and refractory leukemia. Proteasome inhibitors are a promising new class of therapeutics that should be further explored in combination with other chemotherapeutic agents for the treatment of pediatric cancer patients.