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This is a four-drug combination regimen consisting of thalidomide, cyclophosphamide, dexamethasone, and bortezomib. Each component has a distinct mechanism of action: - Thalidomide is an immunomodulatory agent that inhibits angiogenesis and modulates the immune system. - Cyclophosphamide is an alkylating agent that crosslinks DNA, leading to cell death. - Dexamethasone is a synthetic glucocorticoid corticosteroid with anti-inflammatory and cytotoxic effects on lymphoid cells. - Bortezomib is a proteasome inhibitor that disrupts protein degradation pathways in cancer cells. This combination targets multiple pathways involved in the proliferation and survival of malignant plasma cells. It has been investigated primarily for the treatment of multiple myeloma, especially as induction therapy prior to autologous stem cell transplantation or for patients with relapsed/refractory disease. The regimen aims to maximize response rates by combining agents with complementary mechanisms.
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