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Andecaliximab + leucovorin + oxaliplatin + 5-fluorouracil is an investigational four-drug combination regimen for the treatment of advanced gastrointestinal cancers, particularly gastric and gastroesophageal junction adenocarcinoma. **Andecaliximab** is a recombinant chimeric IgG4 monoclonal antibody that selectively inhibits matrix metalloproteinase 9 (MMP9), an extracellular enzyme involved in tumor remodeling, growth, and metastasis. **Leucovorin (folinic acid)** acts as a biomodulator to enhance the cytotoxicity of 5-fluorouracil. **Oxaliplatin** is a platinum-based chemotherapeutic agent causing DNA crosslinking and apoptosis. **5-fluorouracil (5-FU)** inhibits thymidylate synthase, impairing DNA synthesis and cell division in malignant cells. The regimen is typically administered intravenously and has demonstrated promising antitumor activity and a manageable safety profile in phase I/III clinical trials, especially in patients with HER2-negative advanced gastric or gastroesophageal adenocarcinoma[1][3][5].
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