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IMM-101 + folinic acid + fluorouracil + irinotecan + oxaliplatin is a combination regimen that merges the immunotherapeutic agent IMM-101 with the established chemotherapy protocol FOLFIRINOX. IMM-101 is a heat-killed whole cell preparation of Mycobacterium obuense, which acts as an immunomodulator to stimulate dendritic cell maturation and the innate immune response. Folinic acid (leucovorin) enhances the cytotoxic effect of fluorouracil (5-FU), which acts as a pyrimidine analog and antimetabolite inhibiting thymidylate synthase, thus blocking DNA synthesis in rapidly dividing cells. Irinotecan is a topoisomerase I inhibitor, and oxaliplatin is a platinum-based alkylating agent causing DNA crosslinks and apoptosis. This combination targets multiple mechanisms: direct cytotoxicity via DNA damage and inhibition of DNA synthesis and immunomodulation to enhance antitumor responses. The combination, especially FOLFIRINOX, is established for pancreatic and colorectal cancers, with IMM-101 under investigation primarily in pancreatic cancer as an adjunct to chemotherapy[2][5][7].
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