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Evofosfamide (formerly known as TH-302) is a hypoxia-activated prodrug of the DNA alkylator bromo-isophosphoramide mustard. It is selectively activated under hypoxic conditions commonly found in the bone marrow microenvironment of multiple myeloma. Evofosfamide has been investigated in combination with dexamethasone and bortezomib for the treatment of relapsed/refractory multiple myeloma. Dexamethasone is a synthetic glucocorticoid corticosteroid with anti-inflammatory and immunosuppressant properties, while bortezomib is a proteasome inhibitor that disrupts protein degradation pathways, leading to apoptosis in cancer cells. The combination aims to exploit synergistic effects by targeting both hypoxic tumor cells and proteasome-dependent survival mechanisms[1][2][5][6].
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