bortezomib + cyclophosphamide

A two-drug antineoplastic combination consisting of the proteasome inhibitor bortezomib and the alkylating agent cyclophosphamide. Bortezomib reversibly inhibits the 26S proteasome, leading to accumulation of ubiquitinated proteins, disruption of NF-κB signaling, induction of endoplasmic reticulum stress, and apoptosis in myeloma and other malignant cells. Cyclophosphamide is a DNA-alkylating prodrug activated by hepatic cytochrome P450 enzymes to form phosphoramide mustard and acrolein; it induces inter- and intra-strand DNA crosslinks, blocks DNA replication and transcription, and triggers apoptosis. The combination is widely used as a backbone in multiple myeloma regimens (commonly with dexamethasone, VCD/CyBorD) across newly diagnosed, relapsed/refractory, and transplant-eligible settings. It has also been explored in other hematologic malignancies. Bortezomib was originally developed by Millennium (now Takeda); cyclophosphamide is an established generic chemotherapy developed historically by Bayer and widely manufactured.

Other names

bortezomib and cyclophosphamideVCd without dexamethasonebortezomib plus cyclophosphamide