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**Venetoclax + navitoclax + chemotherapy** is an investigational combination therapy for relapsed or refractory acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LL). **Venetoclax** is a small molecule inhibitor that targets BCL2, a protein that prevents apoptosis (programmed cell death) in cancer cells, leading to increased cancer cell death. **Navitoclax** is a small molecule inhibitor of both BCL2 and BCL-XL, and its primary mechanism is to promote apoptosis by inhibiting these anti-apoptotic proteins. Traditional **chemotherapy** agents, which are selected based on institutional/regional ALL/LL protocols, are included to directly kill or inhibit the proliferation of cancer cells through cytotoxic mechanisms. This combination aims to target cancer cells via complementary apoptotic pathways and cytotoxic effects, enhancing treatment efficacy, particularly in heavily pretreated or refractory settings. Clinical trials have shown that the regimen is generally well tolerated (main toxicity: delayed hematopoietic recovery) and demonstrates promising remission rates in high-risk ALL and LL patients, including those following stem cell transplant or immunotherapy[1][2][4][5][6][7].
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