imatinib + pioglitazone + etoricoxib + dexamethasone + treosulfan

This is an oral combination regimen used in clinical trials, primarily for the treatment of castration-resistant prostate cancer (CRPC). The regimen consists of five active pharmaceutical ingredients: - **Imatinib**: A small molecule tyrosine kinase inhibitor primarily targeting BCR-ABL, as well as other relevant kinases (such as PDGF receptors and c-KIT). - **Pioglitazone**: A peroxisome proliferator-activated receptor gamma (PPARγ) agonist, an anti-diabetic thiazolidinedione, with additional anti-inflammatory and differentiation-modulating effects. - **Etoricoxib**: A selective cyclooxygenase-2 (COX-2) inhibitor nonsteroidal anti-inflammatory drug (NSAID) used for anti-inflammatory and analgesic effects. - **Dexamethasone**: A synthetic glucocorticoid corticosteroid with potent anti-inflammatory and immunosuppressive properties. - **Treosulfan**: An alkylating agent with antineoplastic activity, structurally related to busulfan, used in chemotherapy. Mechanistically, this “biomodulatory” combination aims to combine anti-inflammatory, immunomodulatory, angiostatic, and direct antitumor modalities. Clinical investigation supports its use in patients with metastatic castration-resistant prostate cancer, with research into effects on PSA progression. The regimen has been studied under the sponsorship of Novartis Pharma and in collaboration with academic investigators[3][7][5].