panobinostat + carfilzomib + dexamethasone

A combination regimen consisting of **panobinostat** (a pan-histone deacetylase inhibitor), **carfilzomib** (a second-generation selective proteasome inhibitor), and **dexamethasone** (a synthetic glucocorticoid corticosteroid) used experimentally in the treatment of **relapsed and refractory multiple myeloma**. Panobinostat inhibits multiple histone deacetylases, disrupting gene expression, protein homeostasis, and inducing apoptosis. Carfilzomib irreversibly inhibits the 20S proteasome subunit, disrupting protein degradation processes essential for myeloma cell survival. Dexamethasone exerts anti-inflammatory and direct anti-myeloma effects via glucocorticoid receptor activation. This triple combination targets misfolded protein accumulation, cell survival, and cell cycle regulation, demonstrating synergistic activity and durable responses in heavily pre-treated myeloma patients[1][2][4]. The combination has been evaluated in phase 1/2 trials, with common toxicities including thrombocytopenia, gastrointestinal effects, and fatigue[1][2][4].