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The combination of bortezomib, thalidomide, and dexamethasone (often abbreviated as VTD) is a three-drug regimen used primarily in the treatment of multiple myeloma. Bortezomib is a small molecule proteasome inhibitor that disrupts protein degradation within cells, leading to apoptosis of malignant plasma cells. Thalidomide acts as an immunomodulatory agent with antiangiogenic properties and can stimulate immune responses against myeloma cells while inhibiting their growth and blood supply. Dexamethasone is a synthetic glucocorticoid corticosteroid that enhances the efficacy of the other agents by inducing apoptosis in cancerous plasma cells and reducing inflammation. This combination has demonstrated significant activity in both newly diagnosed and relapsed/refractory multiple myeloma patients[2][5]. The regimen is commonly used as induction therapy prior to autologous stem cell transplantation or for patients who are not transplant candidates.
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