PD-1 inhibitor + venetoclax + decitabine + azacitidine

This is a combination regimen consisting of a PD-1 inhibitor (a class of immune checkpoint inhibitors), venetoclax (a BCL-2 inhibitor), decitabine, and azacitidine (both hypomethylating agents). The combination is designed for the treatment of hematologic malignancies, particularly acute myeloid leukemia (AML) in patients who are not candidates for intensive chemotherapy. - **PD-1 inhibitors** block the programmed cell death protein 1 pathway, enhancing T-cell mediated anti-tumor immunity. - **Venetoclax** selectively inhibits BCL-2, promoting apoptosis in malignant cells dependent on this anti-apoptotic protein[3][6]. - **Decitabine** and **azacitidine** are DNA methyltransferase 1 inhibitors that induce hypomethylation of DNA, leading to reactivation of tumor suppressor genes and differentiation or apoptosis of leukemic cells[2][4]. The dual use of both decitabine and azacitidine together with venetoclax and a PD-1 inhibitor is investigational; while combinations such as venetoclax plus either decitabine or azacitidine have demonstrated efficacy in AML[3][5][6], there is limited published data on the quadruple regimen including all four agents.