Proteasome inhibitors are emerging as effective drugs for the treatment of multiple myeloma and possibly certain subtypes of non-Hodgkin's lymphoma. Bortezomib (Velcade) is the first proteasome inhibitor proven to be clinically useful and will soon be followed by a second generation of small molecule inhibitors with improved pharmacological properties. Although it is now understood that certain types of malignancies have an exquisite dependence on a functional proteasome for their survival, the underlying reason(s) remain unclear as of now. In this context, addiction to nuclear factor-jB (NF-jB)-induced survival signals, activation of the unfolded protein response as well as a reduced proteasomal activity in differentiated plasma cells have all been proposed to justify proteasome inhibitors' activity in susceptible tissues. The ubiquitin-proteasome pathway and its relevance to cancerThe ubiquitin-proteasome pathway (UPP) mediates the degradation of polyubiquitinated proteins and represents the main protein degradation pathway in eucaryotic cells. 1 It is estimated that more than 80% of intracellular proteins are degraded by the proteasome. Besides carrying out protein turnover, the UPP plays an essential role in regulating protein levels during cell cycle, apoptosis, response to cellular stress (i.e. DNA damage, hypoxia) and intracellular signal transduction, not to mention its importance for the generation of antigenic epitopes to be presented on human leukocyte antigen (HLA) molecules. It is now known that some types of cancer are exquisitely prone to undergo apoptosis in response to inhibition of the UPP pathway, a phenomenon that, at present, still lacks a precise explanation. 2,3 Intracellular proteins are targeted for degradation by the conjugation of polyubiquitin chains to lysine residues of the protein, a process carried out by ubiquitin-conjugating enzymes and antagonized by deubiquitinating proteases (revised by Nijman et al. 4 ). 1 Ubiquitination is performed by three enzymes: a ubiquitin-activating enzyme (E1), a ubiquitin-conjugating enzyme (E2) and a ubiquitin ligase (E3). E1 activates ubiquitin monomers by adenylation and transfers them to E2, which in turn works in conjunction with E3 to confer substrate specificity. Whereas E1 only exists in two isoforms derived from alternative splicing of the same messenger at least 25 E2 and hundreds of E3 enzymes exist. 1 A similar complexity is shared by the deubiquitinating enzymes, of which more than 500 are represented in the human genome, thus indicating the high complexity and specificity of this regulatory mechanism. 4 The proteasome is an enzymatic complex that recognizes ubiquitin-tagged proteins and catalyses their proteolytic degradation in an ATP-dependent fashion. 1-3 Proteasomes can be found both in the cytoplasm and in the nucleus of eucaryotic cells. The proteasome typically consists of a 20S component, which is normally associated to a 19S or to an 11S (inducible by interferon-g) regulator component. The 20S proteasome component is compris...