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This is a **combination regimen** consisting of pembrolizumab, a humanized monoclonal antibody targeting PD-1 (programmed cell death protein-1); lenalidomide, a small-molecule immunomodulatory agent (IMiD); and dexamethasone, a synthetic glucocorticoid corticosteroid. Pembrolizumab blocks the interaction of PD-1 with its ligands PD-L1 and PD-L2, thereby enhancing T-cell mediated antitumor immune responses. Lenalidomide exerts immunomodulatory, antiangiogenic, and direct antineoplastic effects, and acts synergistically with corticosteroids such as dexamethasone. Dexamethasone provides anti-inflammatory and cytotoxic effects on malignant plasma cells. The combination has been studied for relapsed/refractory and newly diagnosed, transplant-ineligible multiple myeloma. Clinical trials showed anticancer activity in relapsed/refractory disease, but development was halted in newly diagnosed myeloma due to an unfavorable benefit-risk profile[1][3][4][5][6].
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