veliparib + 5-fluorouracil + leucovorin + oxaliplatin + temozolomide

This is an experimental multi-agent oncology regimen combining the oral PARP-1/2 inhibitor veliparib with the cytotoxic agents 5-fluorouracil, oxaliplatin, and temozolomide plus the folate analog leucovorin, designed to exploit synthetic lethality and augment DNA damage in tumor cells. Veliparib inhibits poly(ADP-ribose) polymerase–mediated single-strand DNA break repair, thereby potentiating the cytotoxicity of DNA-damaging chemotherapy such as temozolomide and platinum compounds in homologous recombination–deficient tumors.[1][2] 5-fluorouracil is a thymidylate synthase–inhibiting antimetabolite, leucovorin stabilizes the ternary complex of 5-fluorodeoxyuridine monophosphate with thymidylate synthase to enhance 5-fluorouracil activity, oxaliplatin is a platinum-based DNA cross-linking agent, and temozolomide is an oral DNA-methylating alkylating agent. The combination is being investigated as an intensified antineoplastic regimen in solid tumors where PARP inhibition may sensitize cancer cells to fluoropyrimidine, platinum, and alkylator-based chemotherapy.[1][2]