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This combination therapy consists of the monoclonal antibody bevacizumab (Avastin) administered alongside a 5-fluorouracil (5-FU) based doublet chemotherapy regimen, typically FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) or FOLFIRI (5-fluorouracil, leucovorin, and irinotecan). Developed by Hoffmann-La Roche, this regimen is utilized as a neoadjuvant treatment for patients with previously untreated, unresectable liver-only metastatic colorectal cancer. Bevacizumab functions by binding to vascular endothelial growth factor (VEGF), thereby inhibiting angiogenesis and tumor vascularization. The chemotherapy components provide cytotoxic effects: 5-FU acts as an antimetabolite inhibiting thymidylate synthase, while oxaliplatin causes DNA cross-linking and irinotecan inhibits topoisomerase I, collectively leading to tumor cell death and potential downsizing of metastases to allow for surgical resection.
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