dulanermin + leucovorin + fluorouracil + irinotecan + bevacizumab

**dulanermin + leucovorin + fluorouracil + irinotecan + bevacizumab** is a multi-agent chemotherapy regimen combining an investigational pro-apoptotic agent (dulanermin) with established colorectal cancer chemotherapy drugs (leucovorin, fluorouracil, irinotecan) and the VEGF-targeting monoclonal antibody bevacizumab. - **Dulanermin** is a recombinant human TRAIL (TNF-related apoptosis-inducing ligand) that induces apoptosis in cancer cells via death receptors. - **Leucovorin** (folinic acid) enhances the efficacy of fluorouracil by stabilizing its binding to thymidylate synthase. - **Fluorouracil** (5-FU) is a pyrimidine analog that inhibits thymidylate synthase, impairing DNA synthesis. - **Irinotecan** inhibits topoisomerase I, causing DNA strand breaks during replication. - **Bevacizumab** is a humanized monoclonal antibody that inhibits angiogenesis by binding vascular endothelial growth factor A (VEGF-A), preventing tumor vascularization[1][2][3][4][5][6]. This regimen is investigated primarily for advanced or metastatic colorectal cancer, leveraging multiple mechanisms: promotion of cancer cell apoptosis, inhibition of DNA synthesis and repair, and blockade of tumor angiogenesis.