dexamethasone + floxuridine + fluorouracil + leucovorin + oxaliplatin

This is a multi-agent chemotherapy regimen combining five drugs—dexamethasone, floxuridine, fluorouracil, leucovorin, and oxaliplatin—used primarily in the treatment of colorectal cancer with liver metastases. The regimen typically involves hepatic arterial infusion (HAI) of floxuridine and dexamethasone to target liver tumors directly, while systemic administration of fluorouracil (5-FU), leucovorin (folinic acid), and oxaliplatin addresses both local and extrahepatic disease. - **Dexamethasone** is a synthetic glucocorticoid with anti-inflammatory and immunosuppressive properties; in this context, it helps reduce inflammation associated with HAI therapy. - **Floxuridine** is an antimetabolite that inhibits DNA synthesis by acting as a pyrimidine analog; it is highly effective when delivered via HAI for liver metastases. - **Fluorouracil** is another pyrimidine analog that disrupts DNA synthesis by inhibiting thymidylate synthase. - **Leucovorin** enhances the cytotoxic effects of fluorouracil by stabilizing its binding to thymidylate synthase. - **Oxaliplatin** is a platinum-based alkylating agent that causes DNA crosslinking and apoptosis in rapidly dividing cells[2][7][10]. This combination aims to maximize tumor control within the liver while also treating or preventing systemic disease progression[2][3][5]. It has been studied mainly as adjuvant or conversion therapy after surgical resection or for unresectable metastatic colorectal cancer.