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RRx-001 + irinotecan is an investigational **combination regimen** of the epigenetic and immunomodulatory small molecule RRx-001 with the topoisomerase I inhibitor irinotecan, evaluated primarily for the treatment of treatment-resistant cancers such as advanced colorectal cancer. **RRx-001** is a multi-indication, late-stage molecule with a unique mechanism involving NLRP3 inflammasome inhibition, modulation of macrophage polarization, CD47 antagonism, normalization of tumor vasculature, and pan-epigenetic modification. It generates reactive oxygen/nitrogen species and nitric oxide, impacting DNA methylation and histone acetylation, thereby affecting gene expression and potentially reversing chemoresistance in cancer cells. When combined with irinotecan, RRx-001 aims to resensitize tumors that have become refractory to standard therapies. **Irinotecan** is a well-established topoisomerase I inhibitor used in the treatment of colorectal and other cancers. This combination is being developed and trialed by **EpicentRx** (the developer of RRx-001), with applications in metastatic colorectal cancer, small cell lung cancer, and other solid tumors. In a phase 1 clinical trial (NCT02801097), RRx-001 was co-administered with irinotecan to treatment-resistant cancer patients to test for efficacy and safety[1][2][4]. Route of administration is **intravenous** for both agents[1][2][7]. Key clinical interest includes the regimen’s ability to reverse chemotherapy resistance and improve outcomes in refractory cancers.
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