bevacizumab + fluorouracil + irinotecan + leucovorin + napabucasin

This is a multi-agent investigational combination therapy consisting of five drugs: **Bevacizumab** is a monoclonal antibody targeting vascular endothelial growth factor A (VEGF-A), inhibiting angiogenesis. **Fluorouracil** is an antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis in rapidly dividing cells. **Irinotecan** is a topoisomerase I inhibitor that prevents DNA unwinding and replication. **Leucovorin**, also known as folinic acid, enhances the efficacy of fluorouracil by stabilizing its binding to thymidylate synthase. **Napabucasin (BBI-608)** is an orally administered small molecule bioactivated by NAD(P)H:quinone oxidoreductase 1; it generates reactive oxygen species and inhibits multiple oncogenic pathways including STAT3 signaling, leading to cancer cell death[2][6][8]. The combination has been studied primarily in metastatic colorectal cancer patients who have previously received other treatments[2][8][10]. While earlier studies showed manageable safety profiles for this regimen[2][6], phase III trials did not demonstrate improved overall survival compared to standard regimens[10].

Brand names

Avastin (bevacizumab)None for the full five-drug combination

Other names

FOLFIRI plus bevacizumab plus napabucasinFOLFIRI-BEVACIZUMAB-NAPABUCASIN