BIK and Miyoshi myopathy: It has demonstrated antitumor efficacy, potency, and selectivity comparable to that of carfilzomib in MM, including activity against MM resistant to bortezomib, dexamethasone, or lenalidomide.570 In solid tumors, oprozomib, like carfilzomib, induces apoptosis by increasing the expression of the proapoptotic proteins Bik and Mcl-1.571 However, its oral use is associated with unstable pharmacokinetics and frequent gastrointestinal adverse effects, with 84.6% of patients experiencing varying degrees of nausea.572