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This is a combination chemotherapy regimen consisting of three drugs: - **Fluorouracil (5-FU):** A pyrimidine analog that acts as an antimetabolite, inhibiting thymidylate synthase and interfering with DNA synthesis and repair, as well as RNA processing. It is cell-cycle specific for the S-phase. - **Leucovorin (folinic acid):** Enhances the binding of fluorouracil’s active metabolite to thymidylate synthase, thereby increasing its cytotoxic effect. - **Suramin:** A polysulfonated naphthylurea compound with multiple mechanisms including inhibition of growth factor binding and signaling. It has been investigated for its potential to overcome resistance to 5-FU/leucovorin in colorectal cancer. The combination was studied primarily in metastatic colorectal cancer patients who were resistant to standard 5-FU/leucovorin therapy. However, clinical studies did not support the hypothesis that suramin could overcome this resistance or improve outcomes when added to 5-FU/leucovorin[1][2][10].
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