bortezomib + dexamethasone + doxorubicin + acetyl-l-carnitine

This is a four-drug combination therapy consisting of bortezomib, dexamethasone, doxorubicin, and acetyl-l-carnitine (ALCAR), primarily investigated for the treatment of relapsed or refractory multiple myeloma. Bortezomib is a reversible inhibitor of the 26S proteasome, disrupting protein degradation and inducing apoptosis in malignant cells. Dexamethasone is a synthetic glucocorticoid with anti-inflammatory and immunosuppressive effects. Doxorubicin is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, leading to cytotoxicity in rapidly dividing cells. Acetyl-l-carnitine is included as a neuroprotective agent to reduce the incidence and severity of peripheral neuropathy associated with bortezomib-based regimens[1][4]. This combination has demonstrated high response rates even in heavily pretreated multiple myeloma patients[1].

Brand names

Velcade (bortezomib)Adriamycin (doxorubicin)Decadron (dexamethasone)

Other names

PAD regimen plus acetyl-l-carnitineBDD-A regimen