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PIM447 + ruxolitinib + ribociclib is a triple combination investigational regimen studied primarily in myelofibrosis. - **PIM447** (also called LGH447) is a pan-PIM kinase inhibitor; it blocks the activity of all three PIM kinases (PIM1, PIM2, PIM3), which are proto-oncogenes involved in promoting cell cycle progression and survival, particularly in hematologic malignancies[1][2][4][8]. - **Ruxolitinib** is a Janus kinase (JAK) inhibitor, mainly targeting JAK1 and JAK2, leading to inhibition of aberrant cytokine signaling and reduction of pathological cell proliferation in myeloproliferative disorders. - **Ribociclib** (LEE011, Kisqali) is a cyclin-dependent kinase inhibitor, specifically blocking CDK4 and CDK6, thereby preventing cell cycle progression from G1 to S phase in cancer cells[3][5][6][10]. This combination—administered orally—was tested in phase I trials specifically for the treatment of **myelofibrosis** to assess safety, tolerability, and preliminary efficacy[5][10]. All three components are **small molecule inhibitors** developed or manufactured by Novartis[7][10].
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