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thymosin alpha 1 + capecitabine is a combination therapy investigated for the treatment of hepatocellular carcinoma (HCC), particularly in the postoperative setting. Thymosin alpha 1 is a synthetic 28-amino acid peptide that mimics the naturally occurring thymic hormone responsible for T-cell maturation and immune system enhancement. It acts as an immunomodulator, potentially through Toll-like receptor signaling (TLR2 and TLR9), to stimulate the production of Th1 cytokines and activate cytotoxic T-cells. Capecitabine is an orally administered fluoropyrimidine carbamate prodrug that is converted to 5-fluorouracil (5-FU) by thymidine phosphorylase, an enzyme often overexpressed in tumor tissues. The resulting 5-FU inhibits thymidylate synthase, disrupting DNA synthesis and inducing tumor cell death. The combination aims to leverage the cytotoxic effects of capecitabine alongside the immune-boosting properties of thymosin alpha 1 to reduce recurrence rates and improve survival in HCC patients following surgical resection.
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