Proteasome inhibitors (INN stem –zomib) are drugs that block the action of proteasomes. Proteasomes are large proteins complexes that are used to break down other proteins. These inhibitors are being studied for the treatment of cancer. Drugs such as bortezomib, carfilzomib, and ixazomib are already approved for use in treating multiple myeloma. Proteasome inhibitors are most commonly categorized into two different groups; Synthetic Analogs and Natural products. Synthetic inhibitors are compounds that are all peptide based such as peptide... benzamides, alpha-ketoamides, aldehydes, alpha-ketoaldehydes, vinyl sulfones, and boronic acids. The Natural product inhibitors do not have all of the same core structures and pharmacophores, these natural products are just as selective and potent as the synthetic inhibitors for example lactacystin.

Mechanism

Multiple mechanisms are likely to be involved, but proteasome inhibition may prevent degradation of pro-apoptotic factors such as the p53 protein, permitting activation of programmed cell death in neoplastic cells dependent upon suppression of pro-apoptotic pathways. For example, bortezomib causes a rapid and dramatic change in the levels of intracellular peptides. The most common proteasome inhibitors, stop the proteasome-ubiquitin pathway. It does this by directly targeting the 20S proteasome itself instead of inhibiting the ubiquitination of proteins, or the identification of these substrates

Examples

Approved medications