ibrutinib + bortezomib + rituximab + cyclophosphamide + doxorubicin + vincristine + prednisone

This is a multi-agent combination regimen composed of seven drugs, each with distinct mechanisms of action, used primarily in the treatment of B-cell lymphomas such as diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma. **Ibrutinib** is a small molecule Bruton’s tyrosine kinase (BTK) inhibitor that blocks B-cell receptor signaling, leading to reduced proliferation and survival of malignant B cells. **Bortezomib** is a proteasome inhibitor that disrupts protein degradation pathways, inducing apoptosis in cancer cells. **Rituximab** is a monoclonal antibody targeting CD20 on B lymphocytes, resulting in immune-mediated cell lysis. The remaining agents—cyclophosphamide (alkylating agent), doxorubicin (topoisomerase II inhibitor/anthracycline), vincristine (microtubule inhibitor/vinca alkaloid), and prednisone (synthetic glucocorticoid)—are classic chemotherapeutic drugs with cytotoxic or immunosuppressive effects. This combination aims to maximize anti-tumor efficacy by targeting multiple cellular pathways involved in lymphoma pathogenesis[1][2][3][5]. The regimen has been studied for relapsed/refractory mantle cell lymphoma and high-risk DLBCL.