selinexor + daratumumab + lenalidomide + dexamethasone

This regimen is a **combination therapy** consisting of four agents: - **Selinexor**: a small molecule selective inhibitor of nuclear export (SINE) that targets exportin-1 (XPO1), leading to the nuclear retention and activation of tumor suppressor proteins, resulting in cancer cell apoptosis. - **Daratumumab**: a monoclonal antibody targeting CD38 on multiple myeloma cells, inducing cell death through antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity. - **Lenalidomide**: an immunomodulatory agent that enhances immune activity against myeloma cells, inhibits angiogenesis, and promotes apoptosis of malignant plasma cells. - **Dexamethasone**: a synthetic glucocorticoid steroid with anti-inflammatory and immunosuppressant properties, widely used as part of chemotherapy regimens for its anti-myeloma effects. This specific quadruple combination is **investigational** for newly diagnosed or relapsed/refractory multiple myeloma and has been evaluated in clinical trials but is not yet an FDA-approved regimen as a quadruple therapy. Each drug is individually approved for use in multiple myeloma, and such combinations are being studied for their potential synergistic efficacy and tolerability[1][4][6][7][8].