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This is a combination drug regimen comprised of five agents: - **pembrolizumab**: a monoclonal antibody immune checkpoint inhibitor targeting programmed cell death 1 receptor (PD-1), enhancing T-cell mediated anti-tumor immune response. - **docetaxel**: a cytotoxic small molecule chemotherapy of the taxane class, inhibiting microtubule depolymerization, blocking cell division. - **oxaliplatin**: a platinum-based small molecule chemotherapy, causing DNA crosslinking and apoptosis. - **5-fluorouracil (5-FU)**: a pyrimidine analog small molecule antimetabolite, inhibiting thymidylate synthase, blocking DNA synthesis. - **leucovorin (folinic acid)**: a folate analog used to potentiate 5-FU by stabilizing its binding to thymidylate synthase, enhancing cytotoxicity. This regimen is studied as perioperative therapy for gastric/esophageal/gastroesophageal junction adenocarcinoma in combination with pembrolizumab to increase pathologic response rates, disease-free survival, and overall survival; it is also under investigation for other solid tumors, particularly when combining immunotherapy and multi-agent chemotherapy[1][5].
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