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Pembrolizumab + trifluridine + tipiracil is a combination therapy currently studied for use in advanced gastric cancer. Pembrolizumab is a monoclonal antibody checkpoint inhibitor that targets the programmed cell death protein 1 (PD-1) receptor, thereby enhancing the immune system's ability to detect and destroy cancer cells. Trifluridine and tipiracil, marketed as TAS-102 (Lonsurf), is an oral combination of a nucleoside analog (trifluridine) and a thymidine phosphorylase inhibitor (tipiracil) that together inhibit DNA synthesis and prevent degradation of trifluridine, resulting in cytotoxic activity against tumor cells. This combination is under investigation in phase II trials to determine its efficacy and safety profile in patients with advanced or metastatic gastric cancer who have failed prior therapies with or without anti-PD-1/PD-L1 agents[1][2][8].
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