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This is a combination therapy consisting of four agents: - **Sintilimab** is a fully human IgG4 monoclonal antibody that targets programmed cell death protein 1 (PD-1), blocking its interaction with PD-L1 and PD-L2. This blockade reactivates T cells, enhancing anti-tumor immune responses. Sintilimab is developed by Innovent Biologics and Eli Lilly and Company and approved in China for relapsed or refractory classical Hodgkin lymphoma[1][3][4]. - **Irinotecan** is a small molecule chemotherapeutic agent that inhibits topoisomerase I, leading to DNA damage in rapidly dividing cancer cells. - **Leucovorin folinate** (folinic acid) enhances the efficacy of fluorouracil by stabilizing the binding of its active metabolite to thymidylate synthase. - **Fluorouracil** is an antimetabolite chemotherapeutic agent that inhibits thymidylate synthase, disrupting DNA synthesis. The combination of these drugs leverages both immunotherapy via checkpoint inhibition (sintilimab) and cytotoxic chemotherapy. This regimen has been studied in various advanced solid tumors including gastric cancer, small cell lung cancer, pancreatic cancer, among others[5][6][7]. The addition of sintilimab to standard chemotherapy regimens aims to improve response rates by combining direct tumor cell killing with immune-mediated anti-tumor activity.
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