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The FAM regimen is a combination therapy consisting of three distinct pharmacological agents: fluticasone propionate (an inhaled corticosteroid), azithromycin (a macrolide antibiotic), and montelukast sodium (a leukotriene receptor antagonist). This combination was specifically evaluated in a Phase II clinical trial (NCT01307462) led by Dr. Stephanie J. Lee at the Fred Hutchinson Cancer Research Center for the treatment of new-onset bronchiolitis obliterans syndrome (BOS) in patients who have undergone allogeneic hematopoietic cell transplantation. The regimen is designed to halt the progression of BOS, a severe fibro-inflammatory pulmonary complication of chronic graft-versus-host disease (cGVHD). Fluticasone propionate acts locally in the airways to reduce inflammation, azithromycin provides immunomodulatory effects by potentially inhibiting pro-inflammatory cytokines, and montelukast antagonizes leukotriene-mediated bronchoconstriction and inflammation. The trial demonstrated that the FAM regimen, often administered with a brief systemic steroid pulse, could stabilize lung function and reduce the need for prolonged systemic corticosteroid exposure.
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