futuximab + modotuximab + trifluridine + tipiracil

This is a combination therapy consisting of two monoclonal antibodies, futuximab and modotuximab, administered together with the oral fixed-dose combination of trifluridine and tipiracil. Futuximab and modotuximab are anti-EGFR (epidermal growth factor receptor) monoclonal antibodies that bind to different epitopes on EGFR, leading to inhibition of EGFR signaling pathways involved in tumor cell proliferation and survival. Trifluridine is a nucleoside analog that incorporates into DNA during replication, causing DNA dysfunction and cell death; tipiracil inhibits thymidine phosphorylase, thereby increasing the bioavailability of trifluridine. This regimen has been investigated for use in patients with metastatic colorectal cancer who have wild-type KRAS/NRAS/BRAF genes and have progressed after standard therapies including prior anti-EGFR treatment[2][5][9]. The rationale for combining these agents is to enhance antitumor efficacy by targeting both EGFR-mediated signaling (with futuximab/modotuximab) and DNA synthesis (with trifluridine/tipiracil)[2].