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A combination regimen consisting of **EMD 1201081**, a synthetic phosphorothioate oligodeoxynucleotide and Toll-like receptor 9 (TLR9) agonist, plus **fluorouracil** (5-FU), **cisplatin**, and **cetuximab**—all administered for the first-line treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN). - **EMD 1201081** stimulates innate immunity by binding TLR9 on plasmacytoid dendritic cells and B cells, promoting cytokine and chemokine release and a Th1-type immune response, which has potential antitumor effects. - **Fluorouracil** is an antimetabolite that inhibits thymidylate synthase, impairing DNA synthesis. - **Cisplatin** is a platinum-based alkylating agent, crosslinking DNA and causing apoptosis. - **Cetuximab** is a monoclonal antibody targeting the epidermal growth factor receptor (EGFR), blocking downstream signaling leading to inhibited tumor growth and apoptosis. This combination was investigated for improved efficacy in recurrent/metastatic SCCHN but the trial was terminated.
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