capecitabine + floxuridine + oxaliplatin

This is a combination chemotherapy regimen consisting of three agents—capecitabine, floxuridine, and oxaliplatin. Capecitabine is an oral prodrug that is enzymatically converted to 5-fluorouracil (5-FU) in tumor tissue, where it inhibits DNA synthesis by interfering with thymidylate synthase activity[3]. Floxuridine is a pyrimidine analog and antimetabolite closely related to 5-FU; it also inhibits DNA synthesis after conversion to its active metabolite. Oxaliplatin is a platinum-based chemotherapeutic agent that forms DNA crosslinks, leading to inhibition of DNA replication and transcription and ultimately cell death[5]. This combination targets rapidly dividing cancer cells through multiple mechanisms affecting nucleic acid synthesis and function. While the capecitabine plus oxaliplatin combination (CAPOX/XELOX) is well established for colorectal cancer[1][2][6][7], the addition of floxuridine has been explored in specific settings such as hepatic arterial infusion following resection of liver metastases from colorectal cancer[4].