dexamethasone + floxuridine + leucovorin

This is a combination regimen consisting of dexamethasone, floxuridine, and leucovorin, primarily used as hepatic arterial infusion therapy for the treatment of unresectable liver metastases from colorectal carcinoma. - **Floxuridine** is a pyrimidine analog antimetabolite that inhibits thymidylate synthase, thereby interfering with DNA synthesis and cell replication. - **Leucovorin** (folinic acid) enhances the cytotoxic effects of fluoropyrimidines like floxuridine by stabilizing the binding of their active metabolites to thymidylate synthase. - **Dexamethasone** is a synthetic glucocorticoid corticosteroid added to reduce hepatic toxicity (notably biliary sclerosis) associated with intrahepatic chemotherapy regimens containing floxuridine and leucovorin[1][2][4]. The combination has demonstrated high response rates in both previously untreated and pretreated patients with liver metastases from colorectal cancer, while significantly reducing biliary toxicity compared to regimens without dexamethasone[1][2]. It may also be considered in other settings where hepatic arterial infusion chemotherapy is indicated.