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This is a combination therapy consisting of **ricolinostat**, a selective histone deacetylase 6 (HDAC6) inhibitor; **bortezomib**, a small-molecule proteasome inhibitor; and **dexamethasone**, a synthetic glucocorticoid corticosteroid. Ricolinostat targets HDAC6, disrupting cell stress and autophagic pathways that confer resistance to proteasome inhibitors like bortezomib. Bortezomib inhibits proteasome-mediated degradation of proteins, inducing apoptosis in multiple myeloma (MM) cells. Dexamethasone has anti-inflammatory and cytotoxic effects on lymphoid malignancies. The combination has shown synergistic anti-myeloma activity, particularly in relapsed/refractory multiple myeloma (RRMM), and is intended to enhance overall efficacy and overcome resistance to bortezomib. Recommended phase II dosing for ricolinostat in combination is 160 mg orally once daily with manageable toxicity[1][6][8].
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