FOLFIRINOX + disulfiram + copper gluconate

FOLFIRINOX + disulfiram + copper gluconate is an investigational multi-agent combination therapy primarily studied for advanced and metastatic pancreatic cancer. FOLFIRINOX is a chemotherapy regimen consisting of four drugs: leucovorin calcium (folinic acid), fluorouracil, irinotecan hydrochloride, and oxaliplatin. These agents act synergistically to destroy rapidly dividing cancer cells through various mechanisms including DNA crosslinking, inhibition of topoisomerase I, and disruption of nucleotide synthesis[6][8]. Disulfiram is an FDA-approved drug for chronic alcoholism that has been repurposed in oncology due to its ability to inhibit aldehyde dehydrogenase and disrupt multiple pathways involved in tumor growth. When combined with copper (as copper gluconate), disulfiram forms a complex that induces oxidative stress, ferroptosis-mediated cell death, and inhibits proteasome activity in cancer cells[1][2][3]. This combination has shown potential for overcoming drug resistance and enhancing the cytotoxic effects of chemotherapy. The regimen remains experimental; clinical trials have explored its use as second-line or adjunctive therapy after progression on standard regimens[4][5].

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