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This is a combination regimen of three drugs: azacitidine, ruxolitinib, and selinexor. Azacitidine is a hypomethylating agent that incorporates into DNA and RNA, leading to DNA hypomethylation and direct cytotoxicity in abnormal hematopoietic cells. Ruxolitinib is a Janus kinase inhibitor that targets JAK1 and JAK2, reducing cytokine-mediated signaling involved in myeloproliferative neoplasms. Selinexor is a selective inhibitor of nuclear export (SINE) that blocks export protein 1 (XPO1), resulting in the accumulation of tumor suppressors in the nucleus and promoting cancer cell apoptosis. This triple-drug regimen has been explored for synergistic antineoplastic effects, particularly for advanced or refractory hematologic malignancies such as myelofibrosis or other myeloid neoplasms[6][10]. Each drug has distinct mechanisms targeting different aspects of malignant cell survival.
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