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Sirolimus + methotrexate is a drug combination used primarily for graft-versus-host disease (GVHD) prophylaxis in patients undergoing allogeneic stem cell transplantation. Sirolimus is an mTOR inhibitor that suppresses T-cell activation and proliferation, while methotrexate is an antimetabolite that inhibits dihydrofolate reductase. When combined, these drugs have shown synergistic effects in preventing GVHD, particularly when used alongside tacrolimus. The combination has also demonstrated potential synergy in treating acute lymphoblastic leukemia (ALL), where it has shown promising results in preclinical studies.
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