fludarabine + mitoxantrone + dexamethasone + vorinostat

This is a four-drug combination regimen consisting of fludarabine, mitoxantrone, dexamethasone, and vorinostat. It has been investigated primarily for the treatment of relapsed or refractory mantle cell lymphoma (MCL). Fludarabine is a purine analog antimetabolite that inhibits DNA synthesis by interfering with DNA polymerase alpha, ribonucleotide reductase, and DNA primase. Mitoxantrone is an anthracenedione antineoplastic agent that intercalates into DNA and inhibits topoisomerase II. Dexamethasone is a synthetic glucocorticoid with anti-inflammatory and immunosuppressive properties acting via the glucocorticoid receptor. Vorinostat is a histone deacetylase inhibitor (HDACi) that induces cell cycle arrest and apoptosis in malignant cells by altering gene expression through epigenetic modulation. The combination aims to leverage synergistic cytotoxic effects on malignant lymphocytes but has shown significant toxicity in clinical studies[1][3][7].

Other names

V-FND