ixazomib + clarithromycin

I**xazomib + clarithromycin** is an investigational, orally-administered combination regimen evaluated primarily in the context of treatment for relapsed or refractory multiple myeloma. **Ixazomib** is a small molecule oral proteasome inhibitor that induces apoptosis in myeloma cells by blocking the 20S proteasome, leading to the accumulation of polyubiquitinated proteins and cancer cell death. **Clarithromycin** is a macrolide antibiotic with observed anti-myeloma and immunomodulatory activity, which may include suppression of interleukin-6 and tumor necrosis factor-alpha, and increases dexamethasone exposure by inhibiting hepatic clearance. The combination takes advantage of their complementary mechanisms—proteasome inhibition and immunomodulation—and is entirely oral, aimed at maximizing convenience and efficacy for patients with advanced disease.