melphalan + bortezomib + thalidomide + dexamethasone

This is a four-drug combination regimen consisting of melphalan, bortezomib, thalidomide, and dexamethasone. It is used primarily in the treatment of multiple myeloma, particularly in relapsed or refractory cases and as conditioning before autologous hematopoietic cell transplantation. - **Melphalan** is an alkylating agent that crosslinks DNA and inhibits DNA replication and transcription. - **Bortezomib** is a proteasome inhibitor that disrupts protein degradation pathways leading to apoptosis in myeloma cells. - **Thalidomide** acts as an immunomodulatory agent with antiangiogenic properties and direct antimyeloma effects. - **Dexamethasone** is a synthetic glucocorticoid corticosteroid with anti-inflammatory and cytotoxic activity against lymphoid malignancies. The combination exploits synergistic effects between these agents to enhance antimyeloma activity by targeting different cellular pathways including DNA damage response (melphalan), proteostasis (bortezomib), immune modulation/angiogenesis (thalidomide), and apoptosis induction (dexamethasone). Clinical studies have shown this regimen achieves high response rates in advanced-stage or relapsed/refractory multiple myeloma[1][2][4].

Other names

melphalan bortezomib thalidomide dexamethasone combinationVMDT regimen