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This is a four-drug combination regimen consisting of nab-paclitaxel (albumin-bound paclitaxel), gemcitabine, disulfiram, and copper gluconate. Nab-paclitaxel is a cytotoxic agent that stabilizes microtubules in cancer cells, inhibiting cell division. Gemcitabine is a nucleoside analog that inhibits DNA synthesis in rapidly dividing cells. Disulfiram, traditionally used to treat alcoholism, has shown anticancer activity when combined with copper; the reaction forms a complex (copper diethyldithiocarbamate) that disrupts cancer cell metabolism and induces apoptosis. Copper gluconate serves as the source of copper ions for this effect. This combination has been investigated primarily for metastatic pancreatic cancer patients who have rising CA 19-9 levels while on standard chemotherapy[1][3][8]. The regimen leverages both direct cytotoxicity from chemotherapy and potential chemosensitization/anticancer effects from disulfiram-copper complexes.
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