napabucasin + fluorouracil + oxaliplatin + leucovorin

Napabucasin + fluorouracil + oxaliplatin + leucovorin is an experimental multi-drug combination used in the treatment of advanced or metastatic colorectal cancer. Napabucasin is an oral small molecule that acts as a bioactivatable agent through NAD(P)H:quinone oxidoreductase 1, generating reactive oxygen species, disrupting multiple oncogenic pathways, including STAT3, and inducing cancer cell death. Fluorouracil (5-FU) is a pyrimidine antimetabolite that inhibits thymidylate synthase, interfering with DNA synthesis. Oxaliplatin is a platinum-based cytotoxic agent that forms DNA adducts to inhibit DNA replication and transcription. Leucovorin enhances the efficacy of fluorouracil by stabilizing its binding to thymidylate synthase. This regimen is under investigation for safety and efficacy in metastatic colorectal cancer, often in combination or as part of FOLFOX-type regimens.