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The combination of thalidomide, melphalan, and prednisone (commonly abbreviated as MPT) is an oral regimen used primarily as a first-line treatment for multiple myeloma in patients who are not eligible for high-dose chemotherapy or stem cell transplantation. Thalidomide is an immunomodulatory agent with anti-angiogenic and anti-cancer properties; it works by inhibiting the growth of cancer cells and modulating the immune response. Melphalan is an alkylating agent that crosslinks DNA strands, leading to apoptosis in rapidly dividing cells. Prednisone is a synthetic glucocorticoid corticosteroid that exerts anti-inflammatory and immunosuppressive effects. The MPT regimen has demonstrated improved progression-free survival and overall survival compared to melphalan plus prednisone alone but carries increased risks of peripheral neuropathy (from thalidomide) and myelosuppression (from melphalan). This combination has been considered standard therapy for elderly or transplant-ineligible patients with newly diagnosed multiple myeloma[1][2][4][6].
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