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This combination regimen consists of the anti-angiogenic monoclonal antibody bevacizumab administered alongside one of three fluoropyrimidine-based chemotherapy backbones: LV5FU2 (leucovorin and 5-fluorouracil), FOLFOX (leucovorin, 5-fluorouracil, and oxaliplatin), or FOLFIRI (leucovorin, 5-fluorouracil, and irinotecan). This specific therapeutic strategy was the focus of the PRODIGE 20 trial, a Phase II study conducted by the Centre Hospitalier Universitaire Dijon to evaluate the efficacy and safety of adding bevacizumab to standard first-line chemotherapy in elderly patients (aged 75 years or older) with metastatic colorectal adenocarcinoma. Bevacizumab works by binding to vascular endothelial growth factor (VEGF), thereby inhibiting the growth of new blood vessels that supply the tumor. The chemotherapy components provide additional anti-tumor activity through the inhibition of DNA synthesis and repair via multiple mechanisms, including thymidylate synthase inhibition, DNA alkylation, and topoisomerase I inhibition.
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