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This is a combination chemotherapy and targeted therapy regimen consisting of chronomodulated FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) plus bevacizumab (Avastin). Evaluated by Southwestern Regional Medical Center, the regimen utilizes a chronomodulated delivery system, which schedules drug administration to coincide with the patient's circadian rhythms to potentially minimize toxicity and enhance therapeutic efficacy. 5-fluorouracil is a pyrimidine analog that inhibits thymidylate synthase; leucovorin is a folinic acid derivative that stabilizes the binding of 5-FU to its target; oxaliplatin is a platinum-based agent that forms DNA cross-links; and bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF) to inhibit tumor angiogenesis. This specific combination was investigated in Phase 2 clinical trials for the treatment of metastatic or unresectable colorectal cancer.
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