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A combination regimen of the immunomodulatory small molecule thalidomide and the liposomal formulation of the anthracycline doxorubicin. Thalidomide exerts anti-inflammatory, anti-angiogenic, and immunomodulatory effects, including inhibition of tumor necrosis factor signaling and modulation of regulatory T cells, contributing to antitumor activity in multiple myeloma. Doxorubicin liposome (pegylated liposomal doxorubicin) is a topoisomerase II inhibitor encapsulated in stealth liposomes to modify pharmacokinetics, reduce cardiotoxicity, and enhance tumor delivery. The combination has been studied clinically in relapsed or refractory multiple myeloma, often with dexamethasone, showing high response rates in phase II and case-matched studies, and is used as a multi-agent therapy rather than a fixed-dose co-formulation.
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