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 totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Bortezomib Proteasome inhibitor | 1.3 mg/m² | IV | D1, 4, 8, 11 | |
Doxorubicin Cytotoxic chemotherapy (anthracycline) | 9 mg/m² | IV | D1-4 | |
Dexamethasone Glucocorticoid | 40 mg | Oral | D1, 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- Subcutaneous weekly bortezomib is now standard to reduce neuropathy; VRd or D-VRd have superseded PAD.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
Pegylated liposomal doxorubicin
Platinum-resistant or partially platinum-sensitive ovarian cancer; Kaposi sarcoma
every 28 days
VRd
Newly diagnosed myeloma (with daratumumab as D-VRd in transplant-eligible patients)
every 21 days × 8
D-VRd (PERSEUS)
Newly diagnosed transplant-eligible myeloma: 4 induction cycles, ASCT, 2 consolidation cycles, then D-R maintenance
every 28 days × 4
DRd (daratumumab + lenalidomide + dexamethasone)
Newly diagnosed transplant-ineligible myeloma (MAIA); relapsed myeloma (POLLUX)
every 28 days
High-dose melphalan and autologous stem-cell transplant
Transplant-eligible myeloma after induction
single day × 1
Lenalidomide maintenance
After autologous transplant
every 28 days
Teclistamab
Relapsed or refractory myeloma after 3 or more lines including a PI, IMiD and CD38 antibody
weekly