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D-isoascorbic acid + arsenic trioxide is an investigational combination therapy being developed by Nazarbayev University for the treatment of advanced or metastatic colorectal cancer. This combination therapy is being evaluated in a Phase I/II clinical trial (NCT05721872) for patients who have exhausted standard chemotherapy regimens, such as FOLFOX and FOLFIRI. The treatment strategy utilizes the synergistic effects of D-isoascorbic acid (a vitamin C analog) and arsenic trioxide to induce cancer cell death. Arsenic trioxide acts by disrupting mitochondrial function and increasing the production of reactive oxygen species (ROS), while D-isoascorbic acid further enhances oxidative stress and depletes cellular antioxidant defenses, leading to ROS-dependent apoptosis. This approach specifically targets the metabolic vulnerabilities of colorectal cancer cells that have become resistant to conventional therapies.
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