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**Ruxolitinib + methylprednisolone + lenalidomide** is an investigational three-drug combination therapy for relapsed/refractory multiple myeloma and related hematological malignancies. Ruxolitinib is a selective inhibitor of Janus kinase 1 and 2 (JAK1/JAK2) that modulates inflammatory and immune signaling. Methylprednisolone is a synthetic glucocorticoid steroid with immunosuppressive and anti-inflammatory actions. Lenalidomide is an immunomodulatory agent (IMiD) with anti-angiogenic, anti-proliferative, and immune-activating properties, primarily acting through modulation of cereblon to facilitate targeted protein degradation, and is a derivative of thalidomide. The rationale for combining these agents is to overcome lenalidomide and steroid resistance in heavily treated multiple myeloma patients, leveraging the synergistic anti-myeloma activity observed in preclinical and early clinical trials. This combination is still in early-stage clinical development for patients with relapsed/refractory multiple myeloma who have experienced disease progression on prior regimens[4][7][9].
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