tucatinib + trastuzumab + pembrolizumab + fluorouracil + leucovorin + oxaliplatin

This is a combination regimen of six anti-cancer agents targeting HER2-positive gastrointestinal malignancies. **Tucatinib** is a selective oral small molecule tyrosine kinase inhibitor that targets human epidermal growth factor receptor 2 (HER2). **Trastuzumab** is a monoclonal antibody against HER2, inhibiting downstream signaling and promoting antibody-dependent cellular cytotoxicity. **Pembrolizumab** is a PD-1 immune checkpoint inhibitor (monoclonal antibody), enhancing immune-mediated tumor cell killing. **Fluorouracil** is a pyrimidine antimetabolite that inhibits thymidylate synthase, interfering with DNA synthesis. **Leucovorin** enhances the antitumor effect of fluorouracil by stabilizing its binding to thymidylate synthase. **Oxaliplatin** is a platinum-based small molecule chemotherapy inducing DNA crosslinking and apoptosis. This intensive combination is being studied primarily for HER2-positive gastrointestinal cancers including gastric, colorectal, and other GI tract cancers, with the goal of leveraging complementary mechanisms of action: HER2 blockade, immunotherapy, and cytotoxic chemotherapy[1][3][4].

Other names

FOLFOX