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This is a **three-drug combination regimen** consisting of **indoximod** (an oral small-molecule immunomodulator and tryptophan metabolism pathway inhibitor), **idarubicin** (an anthracycline antineoplastic agent), and **cytarabine** (a nucleoside analog antimetabolite). Indoximod inhibits the IDO (indoleamine 2,3-dioxygenase) pathway, which is associated with immune evasion by tumor cells. Idarubicin intercalates into DNA and inhibits topoisomerase II, leading to DNA strand breaks and apoptosis in rapidly dividing cells. Cytarabine is phosphorylated to its active form within leukemic cells and inhibits DNA synthesis by terminating DNA chain elongation. The three agents combined are studied primarily in **acute myeloid leukemia (AML)**, especially as part of **induction therapy** in newly diagnosed AML, for synergistic antitumor and immunomodulating effects[4][1][2][5][3]. Indoximod is an investigational drug, developed by NewLink Genetics, while idarubicin and cytarabine are widely used chemotherapeutic agents.
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