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CHOP + selinexor + 5-azacitidine is an investigational combination regimen composed of the standard CHOP chemotherapy backbone (cyclophosphamide, doxorubicin, vincristine, and prednisone), the selective nuclear export inhibitor selinexor, and the hypomethylating agent 5-azacitidine. - **CHOP** is a well-established multi-agent chemotherapy regimen used primarily for non-Hodgkin lymphoma. Cyclophosphamide is an alkylating agent that crosslinks DNA; doxorubicin intercalates into DNA and inhibits topoisomerase II; vincristine disrupts microtubule formation; prednisone is a corticosteroid with lympholytic effects[3][4][7]. - **Selinexor** inhibits exportin 1 (XPO1), leading to nuclear retention of tumor suppressor proteins and induction of apoptosis in malignant cells. - **5-Azacitidine** is a nucleoside analog that incorporates into RNA and DNA, inhibiting DNA methyltransferase activity and resulting in hypomethylation of DNA as well as direct cytotoxicity to abnormal hematopoietic cells. This combination aims to leverage multiple mechanisms—cytotoxicity from CHOP, epigenetic modulation from 5-azacitidine, and targeted disruption of nuclear-cytoplasmic transport by selinexor—to enhance antitumor efficacy in aggressive hematologic malignancies.
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