cisplatin + cixutumumab + pemetrexed

This is a combination regimen consisting of three agents: - **Cisplatin** is a platinum-based chemotherapeutic that forms DNA crosslinks, leading to apoptosis in rapidly dividing cells. - **Cixutumumab** is a fully human IgG1 monoclonal antibody targeting the insulin-like growth factor 1 receptor (IGF-1R), inhibiting its activation and downstream PI3K/AKT signaling, which can reduce tumor cell proliferation and survival[1][2][4]. - **Pemetrexed** is an antifolate antineoplastic agent that inhibits multiple folate-dependent enzymes involved in nucleotide synthesis, thereby blocking DNA and RNA synthesis. This combination has been investigated primarily for the treatment of various solid tumors, including non-small cell lung cancer. Cixutumumab was developed by ImClone Systems (later acquired by Eli Lilly) but has since been discontinued from active development due to lack of efficacy in late-stage trials[4][5].