OnCo

PAD (bortezomib, doxorubicin, dexamethasone)

Checked 2026-09-09

Induction before autologous transplant in newly diagnosed multiple myeloma (HOVON-65/GMMG-HD4); largely replaced by VRd and daratumumab combinations

Also called PAD, Bortezomib-doxorubicin-dexamethasone.

One cycle

every 21 days × 3 · about 9 weeks in total
178141521Bortezomib: 1.3 mg/m², IntravenousBortezomibDoxorubicin: 9 mg/m², IntravenousDoxorubicinDexamethasone: 40 mg, OralDexamethasone
21-day cycle × 3 (about 9 weeks)IntravenousOral Daily oral course

Components

DrugDoseRouteDays
Bortezomib
Proteasome inhibitor
1.3 mg/m²IVD1, 4, 8, 11
Doxorubicin
Cytotoxic chemotherapy (anthracycline)
9 mg/m²IVD1-4
Dexamethasone
Glucocorticoid
40 mgOralD1, 2, 3, 4, 9, 10, 11, 12
Cycles
3
21-day cycle
Emetogenicity
Moderate (30-90%)
G-CSF
Not routine

Notes

  • Bortezomib-based induction improved response and progression-free survival over VAD and helped patients with del(17p).
  • Subcutaneous weekly bortezomib is now standard to reduce neuropathy; VRd or D-VRd have superseded PAD.

Used in

Source

Sonneveld (HOVON-65/GMMG-HD4), JCO 2012: bortezomib induction and maintenance versus VAD

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.

Other regimens for these cancers