asparaginase + PD-1 antibody + bortezomib

This is a combination regimen consisting of three agents: - Asparaginase (or its pegylated form, pegaspargase), an enzyme that depletes the amino acid asparagine, leading to inhibition of protein synthesis and apoptosis in certain cancer cells, particularly lymphoid malignancies. - PD-1 antibody (anti-PD-1), a monoclonal antibody targeting the programmed cell death protein 1 (PD-1) receptor on T cells, blocking its interaction with ligands and thereby enhancing anti-tumor immune responses. Examples include tislelizumab and pembrolizumab. - Bortezomib, a small molecule proteasome inhibitor that disrupts the ubiquitin-proteasome pathway, resulting in cell cycle arrest and apoptosis in malignant cells. This triple-agent regimen has been investigated for use in newly diagnosed early-stage extranodal natural killer/T-cell lymphoma (ENKTL). The combination aims to leverage direct cytotoxicity from asparaginase/pegaspargase and bortezomib with immune checkpoint blockade from the PD-1 antibody. Early clinical studies suggest promising efficacy with manageable toxicity profiles for this novel approach[6].