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mFOLFOX6 + pembrolizumab is a combination regimen used primarily in the treatment of gastrointestinal cancers, including colorectal and gastric/gastroesophageal junction (GEJ) adenocarcinoma. The mFOLFOX6 component consists of oxaliplatin, leucovorin, and 5-fluorouracil (5-FU), which together act as cytotoxic chemotherapeutic agents. Oxaliplatin induces DNA crosslinking leading to apoptosis; 5-FU inhibits thymidylate synthase disrupting DNA synthesis; leucovorin enhances the binding of 5-FU to its target enzyme. Pembrolizumab is a humanized monoclonal antibody that targets programmed cell death receptor-1 (PD-1), blocking its interaction with PD-L1 and PD-L2, thereby enhancing T-cell mediated immune responses against tumor cells[3][4][8]. This combination aims to increase immunogenic cell death and improve outcomes by combining direct cytotoxicity with immune checkpoint inhibition[5][8].
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