nal-IRI + oxaliplatin + 5-fluorouracil + leucovorin + PD-1

This is a multi-agent investigational combination regimen consisting of five components: - **nal-IRI (nanoliposomal irinotecan):** A liposomal formulation of irinotecan, a topoisomerase I inhibitor that interferes with DNA replication in cancer cells. - **Oxaliplatin:** A platinum-based chemotherapeutic agent that forms DNA crosslinks, inhibiting DNA synthesis and transcription. - **5-Fluorouracil (5-FU):** An antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis and cell division. - **Leucovorin:** A reduced folate used to enhance the binding of 5-FU to thymidylate synthase, increasing its cytotoxicity. - **PD-1 inhibitor:** Refers to an immune checkpoint inhibitor targeting programmed cell death protein 1 (PDCD1), which enhances T-cell mediated anti-tumor immunity. This combination is being explored for synergistic anti-tumor effects by combining cytotoxic chemotherapy with immunotherapy. The primary indications under investigation are advanced gastrointestinal cancers such as colorectal or pancreatic cancer. The regimen leverages both direct tumor cell killing and immune system activation.