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**CF10** is an investigational, second-generation polymeric fluoropyrimidine developed from the F10 platform. It is a chemically modified oligonucleotide composed of fluorodeoxyuridylate monomers in a single-stranded DNA-based polymer designed to generate the active fluoropyrimidine metabolite FdUMP more directly than 5-fluorouracil. CF10 produces dual antitumor activity through potent inhibition of thymidylate synthase and trapping of DNA topoisomerase I cleavage complexes, causing thymidine depletion, replication stress, DNA damage, and cancer-cell death. It originated at Wake Forest University School of Medicine and is being advanced by Deep Creek Pharma as a late-preclinical candidate for colorectal cancer, including metastatic and 5-fluorouracil-refractory disease, with additional preclinical work in pancreatic ductal adenocarcinoma, small cell lung cancer, and acute myeloid leukemia.
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