idasanutlin + fludarabine + cytarabine

A three-drug combination consisting of **idasanutlin**, **fludarabine**, and **cytarabine**. - **Idasanutlin** is a selective, orally bioavailable small molecule **MDM2 antagonist**, which inhibits the murine double minute 2 (MDM2) protein, leading to activation of the p53 tumor suppressor pathway, promoting apoptosis in cancer cells with functional (wild-type) p53. - **Fludarabine** is a purine analog that interferes with DNA synthesis and repair and has immunosuppressive and antineoplastic activity. - **Cytarabine** (ara-C) is a nucleoside analog that inhibits DNA synthesis, primarily used to treat acute myeloid leukemia (AML) and related hematologic malignancies. This combination has been explored for the treatment of **relapsed or refractory acute myeloid leukemia (AML)**. While the two-drug combination (idasanutlin + cytarabine) has been the focus of major Phase III studies, the triple combination (idasanutlin + fludarabine + cytarabine) is not the subject of completed late-stage studies, but the rationale would be potential synergistic antileukemic activity leveraging multiple mechanisms of action.