chidamide + bortezomib + lenalidomide + dexamethasone

This is a four-drug combination regimen consisting of chidamide, bortezomib, lenalidomide, and dexamethasone. Chidamide is a selective histone deacetylase inhibitor (HDACi) that modulates gene expression and induces apoptosis in malignant cells. Bortezomib is a proteasome inhibitor that disrupts protein degradation pathways, leading to cell cycle arrest and apoptosis in cancer cells. Lenalidomide is an immunomodulatory agent with anti-angiogenic and direct antineoplastic effects. Dexamethasone is a synthetic glucocorticoid corticosteroid with anti-inflammatory and cytotoxic properties against lymphoid malignancies. The combination has been investigated primarily for the treatment of multiple myeloma, particularly high-risk or refractory/relapsed cases. Preclinical studies indicate synergistic cytotoxicity when combining chidamide with either bortezomib or lenalidomide[3][5][7][9]. Clinical trials are ongoing to compare this quadruplet regimen to standard triplet regimens for efficacy and safety in multiple myeloma patients[1][3].