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**IMM-1-104 + folinic acid + fluorouracil + irinotecan + oxaliplatin** is an investigational combination regimen consisting of the novel, oral, small molecule MEK inhibitor **IMM-1-104** together with the modified FOLFIRINOX chemotherapy backbone. IMM-1-104 is designed for deep cyclic inhibition of the MEK component of the MAPK pathway, aiming to overcome resistance and toxicity associated with chronic MAPK inhibition. Folinic acid (calcium folinate) potentiates the effects of fluorouracil (5-FU), which exerts antimetabolite action by interfering with DNA synthesis in cancer cells. Irinotecan is a topoisomerase I inhibitor causing DNA damage and cell death, while oxaliplatin is a platinum-based alkylating agent that leads to DNA cross-linking and apoptosis. This combination has shown promising anti-tumor activity and tolerability in early-phase clinical trials for pancreatic cancer, including complete and partial responses and disease control across evaluable patients[3][5]. IMM-1-104 is developed by Immuneering, and modified FOLFIRINOX is a standard regimen often used in gastrointestinal cancers.
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