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Mitoxantrone hydrochloride liposome + rituximab + lenalidomide is an investigational chemo-immunotherapy combination regimen being evaluated for the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL). The regimen includes **mitoxantrone hydrochloride liposome** (Duoenda), a nanoparticle-encapsulated anthracenedione that intercalates into DNA and inhibits topoisomerase II while reducing cardiotoxicity compared to conventional mitoxantrone. **Rituximab** is a chimeric monoclonal antibody that targets the CD20 antigen on B-lymphocytes, inducing cell death through antibody-dependent cellular cytotoxicity (ADCC), complement-dependent cytotoxicity (CDC), and apoptosis. **Lenalidomide** is an oral immunomodulatory drug (IMiD) that binds to the cereblon E3 ubiquitin ligase complex, leading to the degradation of transcription factors Ikaros and Aiolos, which results in direct antineoplastic effects and enhancement of T-cell and NK-cell mediated immunity. This triplet combination is currently being studied in Phase 2 clinical trials led by Jianfeng Zhou at Tongji Hospital to improve outcomes in patients with aggressive B-cell malignancies.
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