Chemotherapy Release From Bortezomib-Impregnated Polymethylmethacrylate-Coated Intramedullary Nails: A Novel In Vitro Study for a Local Chemotherapy Delivery Device.

Bortezomib (BAN) is a proteasome inhibitor approved for the treatment of multiple myeloma and lymphoma. Despite its efficacy in various tumor models, systemic administration can result in toxicity to healthy organs. The purpose of this study is to evaluate the elution profile of BAN from PMMA cement for the local treatment of orthopedic tumors. BAN solution (5 mg; 2 mg/mL) was mixed with Simplex cement (40 g, Stryker), followed by injection of cement into an antibiotic cement nail mold (13 mm) to coat a 10 mm titanium femoral nail (DePuy Synthes). Once the cement polymerized, the nail was cut into 2 cm segments for the BAN elution study. There is a sustained release of BAN for up to 28 days. The overall concentration of BAN released at each time point was between 74 and 263 ng/ml, which is compatible with the peak blood concentration of a single intravenous BAN injection. This study demonstrates the feasibility of using PMMA bone cement as a local BAN delivery tool, essential for future studies and treatment targeting multiple myeloma cells.