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5-fluorouracil + levamisole is a combination chemotherapy regimen used as adjuvant therapy following surgical resection of stage III (Dukes' C) colon cancer. 5-fluorouracil (5-FU) is an antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis and leading to cell death in rapidly dividing tumor cells. Levamisole, originally developed as an antihelminthic agent, acts as an immunomodulator and enhances the immune response against tumor cells. The combination has been shown to significantly reduce recurrence rates and improve overall survival compared to observation or either drug alone in patients with high-risk colon cancer[1][2][3]. Mechanistically, research suggests that levamisole may offset some of the RNA synthesis suppression caused by 5-FU and augment its therapeutic benefit by modulating messenger RNAs involved in immune system protein production[3].
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