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INTRODUCTION: The emergence of drug resistance poses a serious threat to cancer chemotherapy by a single agent. Tumor cell heterogeneity, mutation, and/or desensitization of receptor render monotherapy ineffective. Combination encompassing multiple targets or biochemical pathways seems promising for cancer treatment. Combination of HDAC inhibitor(s) with other inhibitor(s) has shown synergistic activity in cancer chemotherapy by modulating a variety of therapeutic targets including epigenetic target of cancer cells by restoring acetylation and reactivating tumor suppressor genes leading to cell cycle arrest, promoting apoptosis, and thus inhibiting cancer cell proliferation. AREAS COVERED: A comprehensive published patent literature (2020-present) on rational combinations of HDAC inhibitor(s) for cancer chemotherapy has been retrieved and reviewed from various patent databases including Google Patents, Espacenet, Patentscope, WIPO, and USPTO to analyze the rational combinations for better, optimized, and precise cancer therapy. In this second part of two-part review, we highlighted the patent published for the combination. EXPERT OPINION: The HDAC inhibitor(s) in combination with other therapeutically relevant inhibitor(s) such as MAPK, GSK3, PI3K/mTOR, PARP, CDK9, HSP90, BTK, BRD4, JAK, VEGF, ALK, PD-1, or PDE inhibitor showed synergistic anti-cancer activity. These combinations not only overcame drug resistance but also acted against relapsed/refractory cancers.
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Shukla et al. (2025) studied this question.
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