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mFOLFIRINOX + algenpantucel-L is a chemo-immunotherapy combination investigated for the treatment of pancreatic cancer. The regimen consists of a modified FOLFIRINOX chemotherapy backbone (comprising 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and algenpantucel-L, an allogeneic cancer vaccine. Algenpantucel-L is composed of two irradiated allogeneic pancreatic cancer cell lines (HAPa-1 and HAPa-2) genetically engineered to express alpha-1,3-galactosyl epitopes (alpha-gal). The presence of these epitopes on the vaccine cells triggers a hyperacute rejection-like immune response, stimulating the patient's immune system to recognize and attack endogenous pancreatic cancer cells. The modified FOLFIRINOX component provides a cytotoxic effect by inhibiting DNA synthesis and repair, typically administered with reduced irinotecan doses and the omission of the 5-FU bolus to improve tolerability compared to the original FOLFIRINOX regimen.
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