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A combination therapy consisting of pegylated liposomal doxorubicin (Doxil) and the P-glycoprotein (P-gp) inhibitor valspodar (PSC 833). Doxorubicin is an anthracycline chemotherapy agent that works by intercalating DNA and inhibiting topoisomerase II, leading to cell death. Valspodar is a non-immunosuppressive cyclosporine D derivative that acts as a potent inhibitor of the MDR1 efflux pump (P-glycoprotein). The rationale for this combination is to overcome multidrug resistance in tumors like Kaposi's sarcoma and advanced solid tumors, where P-gp expression often limits the efficacy of doxorubicin by pumping the drug out of the cells. This specific combination was investigated in a Phase 1 study by Washington University School of Medicine to determine the maximum tolerated dose and toxicity profile.
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