pomalidomide + doxorubicin + dexamethasone

This is a combination regimen consisting of three drugs—pomalidomide, doxorubicin, and dexamethasone—used primarily in the treatment of relapsed or refractory multiple myeloma. - **Pomalidomide** is an immunomodulatory agent (IMiD) with antimyeloma activity. It works by disrupting interactions between myeloma cells and the bone marrow microenvironment, downregulating cytokines and growth factors necessary for tumor survival, inhibiting angiogenesis, inducing apoptosis in malignant cells, and enhancing immune responses through T-cell and natural killer cell activation[8][6]. - **Doxorubicin** is an anthracycline antibiotic that intercalates DNA strands, inhibits topoisomerase II activity leading to DNA damage, and generates free radicals that induce cytotoxicity in rapidly dividing cancer cells. - **Dexamethasone** is a synthetic glucocorticoid corticosteroid with anti-inflammatory and immunosuppressive properties; it also induces apoptosis in certain hematologic malignancies such as multiple myeloma[5][9]. The combination has been studied as a salvage therapy for patients with relapsed/refractory multiple myeloma who have failed prior lines of treatment including lenalidomide (another IMiD) and proteasome inhibitors. The triplet regimen aims to leverage synergistic effects among these agents to improve response rates compared to single-agent or doublet therapies[2][4].