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Lenalidomide + chlorambucil is a combination of two small molecule drugs used in the treatment of hematologic malignancies, particularly chronic lymphocytic leukemia (CLL) in elderly or unfit patients. Lenalidomide is an immunomodulatory agent that exerts antineoplastic effects through multiple mechanisms, including direct cytotoxicity to tumor cells, inhibition of angiogenesis, and modulation of the immune system by enhancing T cell and natural killer cell function. Chlorambucil is an alkylating agent that interferes with DNA replication and transcription by forming cross-links within DNA strands, leading to apoptosis in rapidly dividing cells. This combination has been studied as part of multi-drug regimens for CLL but is not a standard approved therapy outside clinical trials due to toxicity concerns associated with lenalidomide in this population[1][2][3].
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