indoximod + gemcitabine + nab-paclitaxel

This is a combination therapy consisting of **indoximod**, an oral small molecule inhibitor targeting the indoleamine 2,3-dioxygenase (IDO) pathway; **gemcitabine**, a nucleoside analog chemotherapeutic agent inhibiting DNA synthesis; and **nab-paclitaxel** (nanoparticle albumin-bound paclitaxel), a microtubule inhibitor formulated to improve paclitaxel delivery. Indoximod is designed to counteract IDO-mediated immune suppression in the tumor microenvironment, thereby potentially enhancing anti-tumor immune responses. Gemcitabine and nab-paclitaxel make up a standard chemotherapy backbone for metastatic pancreatic cancer. The combination has been investigated as a first-line treatment for metastatic pancreatic adenocarcinoma in a multi-arm phase I/II clinical trial, with indoximod dosed orally (up to 1200mg twice daily) and chemotherapy administered intravenously in 28-day cycles. The regimen aims to improve overall survival and objective response rates compared to standard chemotherapy[2][3][5][7].