QLS32015 + bortezomib + lenalidomide

This is a **combination therapy** under clinical investigation for multiple myeloma, composed of QLS32015, bortezomib, and lenalidomide. - **QLS32015**: The precise molecular nature and mechanism of action of QLS32015 is not specified in the trial record, but it is being developed by Qilu Pharmaceutical and administered subcutaneously. - **Bortezomib**: A small molecule proteasome inhibitor that induces apoptosis in myeloma cells by inhibiting the 26S proteasome, leading to cell-cycle arrest and apoptosis via the activation of both mitochondrial and caspase pathways, as well as inhibition of nuclear factor κ-B signaling. - **Lenalidomide**: An immunomodulatory drug (IMiD) that primarily induces apoptosis by activation of caspase-8, downregulation of nuclear factor κ-B activity, and targeting of IKZF1 (Ikaros) for degradation. In combination with bortezomib, their synergistic pro-apoptotic action in multiple myeloma involves both proteasome-dependent and calcium-induced calpain pathways.