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nadunolimab + FOLFIRINOX is an investigational combination therapy for advanced or metastatic pancreatic ductal adenocarcinoma (PDAC). Nadunolimab is a monoclonal antibody targeting the interleukin-1 receptor accessory protein (IL1RAP), designed to block IL1α/IL1β signaling and enhance antibody-dependent cellular cytotoxicity, thereby modulating tumor inflammation and immune evasion. FOLFIRINOX is a multi-agent chemotherapy regimen consisting of folinic acid (leucovorin), fluorouracil (5-FU), irinotecan, and oxaliplatin, each contributing distinct mechanisms targeting DNA synthesis and repair, and cell replication. Preliminary clinical and preclinical studies suggest the combination may provide additive antitumor activity, improved survival, and a reduction in chemotherapy-induced peripheral neuropathy (CIPN), compared to standard regimens. The combination is currently being evaluated in clinical trials, such as CAPAFOUR, for safety, biomarkers, and efficacy in first-line treatment of metastatic PDAC[1][7].
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