oprozomib + pomalidomide + dexamethasone

The combination of **oprozomib, pomalidomide, and dexamethasone** is an investigational oral triplet regimen primarily studied for the treatment of relapsed and/or refractory multiple myeloma (RRMM). Oprozomib is a second-generation oral proteasome inhibitor related to carfilzomib that irreversibly inhibits the chymotrypsin-like activity of the 20S proteasome, leading to disruption of protein homeostasis and apoptosis in myeloma cells. Pomalidomide is an immunomodulatory agent (IMiD) that exerts anti-myeloma effects through multiple mechanisms including direct cytotoxic effects on myeloma cells, inhibition of stromal cell support for myeloma growth, and enhancement of immune cell function. Dexamethasone is a synthetic corticosteroid with anti-inflammatory and cytotoxic effects. This triplet aims to exploit the synergistic action between proteasome inhibition and immunomodulation. The combination has demonstrated clinical activity in patients with RRMM previously treated with both immunomodulatory and proteasome inhibitor drugs, showing overall response rates around 50–60% in preliminary phase Ib/II studies and a tolerable safety profile, although the optimal dosing of oprozomib is still under investigation[5][3].