Table 1.

Recommended dose modification for bortezomib-related neuropathy and/or neuropathic pain (NCI 2003)

Severity	Signs and symptoms of peripheral neuropathy	Dose modification
Grade 1	Asymptomatic; loss of deep tendon reflexes or parathesia (including tingling) but not interfering with function	No action
Grade 2 or Grade 1 with pain	Sensory alteration or parathesia (including tingling) interfering with function but not with ADL	Reduce bortezomib to 1.0 mg/m2 (25% dose reduction)
Grade 3 or Grade 2 with pain	Sensory alteration or parathesia interfering with ADL	Withhold bortezomib until toxicity resolves then restart at 0.7 mg/m2 (50% dose reduction)
Grade 4	Permanent sensory loss interfering with function (disabling)	Discontinue bortezomib

Abbreviations: ADL, activities of daily living.