dexamethasone + rituximab + cyclophosphamide + bortezomib

This is a combination regimen consisting of four drugs—dexamethasone, rituximab, cyclophosphamide, and bortezomib—used primarily in the treatment of hematologic malignancies such as multiple myeloma, mantle cell lymphoma, and Waldenström macroglobulinemia. - **Dexamethasone** is a synthetic glucocorticoid corticosteroid with anti-inflammatory and immunosuppressive properties. - **Rituximab** is a monoclonal antibody targeting CD20 on B lymphocytes, leading to their depletion. - **Cyclophosphamide** is an alkylating agent that crosslinks DNA strands to inhibit cell division and induce apoptosis in rapidly dividing cells. - **Bortezomib** is a small molecule proteasome inhibitor that disrupts protein degradation pathways within cancer cells, leading to apoptosis[6][7][8]. The combination leverages multiple mechanisms—immune modulation (rituximab), cytotoxicity (cyclophosphamide), targeted protein degradation inhibition (bortezomib), and anti-inflammatory/immunosuppression (dexamethasone)—to achieve synergistic antitumor effects.