btk inhibitor + xpo1 inhibitor + rituximab + gemcitabine + oxaliplatin

This is a multi-agent combination regimen consisting of a Bruton's tyrosine kinase (BTK) inhibitor, an exportin 1 (XPO1) inhibitor, rituximab, gemcitabine, and oxaliplatin. - **BTK inhibitors** are small molecules that block Bruton's tyrosine kinase, disrupting B-cell receptor signaling and leading to apoptosis in malignant B cells. - **XPO1 inhibitors** (such as selinexor) block the nuclear export protein exportin 1 (XPO1), resulting in the accumulation of tumor suppressor proteins in the nucleus and induction of cancer cell death[2][1]. - **Rituximab** is a monoclonal antibody targeting CD20 on B lymphocytes, mediating cell lysis via immune mechanisms. - **Gemcitabine** is a nucleoside analog that inhibits DNA synthesis by incorporation into DNA strands during replication. - **Oxaliplatin** is a platinum-based chemotherapeutic agent causing DNA crosslinking and apoptosis. The R-GemOx regimen (rituximab + gemcitabine + oxaliplatin) has demonstrated efficacy and tolerability for relapsed/refractory diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, follicular lymphoma, Hodgkin lymphoma, especially in patients not eligible for high-dose chemotherapy or stem cell transplantation[3][4][5][6][7]. The addition of BTK inhibitors and XPO1 inhibitors represents an investigational approach aiming to enhance anti-tumor activity through complementary mechanisms.