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The combination of bortezomib, melphalan, and prednisone (commonly referred to as the VMP regimen) is a standard first-line therapy for newly diagnosed multiple myeloma patients who are ineligible for high-dose therapy with autologous stem cell transplantation. - **Bortezomib** is a proteasome inhibitor that disrupts the degradation of ubiquitinated proteins, leading to apoptosis in cancer cells. - **Melphalan** is an alkylating agent that crosslinks DNA and inhibits DNA and RNA synthesis, resulting in cytotoxicity primarily in rapidly dividing cells. - **Prednisone** is a synthetic corticosteroid with anti-inflammatory and immunosuppressive properties; it induces apoptosis in certain hematologic malignancies. This combination exploits synergistic antineoplastic effects by targeting multiple pathways involved in myeloma cell survival[1][3]. The regimen has demonstrated improved progression-free survival compared to older regimens such as melphalan plus prednisone alone[3].
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