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This is a combination chemotherapy regimen consisting of arsenic trioxide (ATO), fluorouracil (5-FU), and leucovorin (LV). Arsenic trioxide is known for its ability to downregulate thymidylate synthase (TS), thereby resensitizing tumor cells that have become resistant to 5-fluorouracil. Fluorouracil is an antimetabolite that inhibits DNA synthesis by targeting TS, while leucovorin enhances the binding of 5-FU to TS, increasing its cytotoxicity. This combination has been investigated primarily in patients with relapsed or refractory metastatic colorectal cancer who have failed prior therapies. The regimen aims to improve the efficacy of standard fluoropyrimidine-based chemotherapy by overcoming resistance mechanisms through TS modulation[1][2][6].
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