floxuridine + irinotecan + oxaliplatin

This is a combination chemotherapy regimen consisting of three small-molecule cytotoxic agents—floxuridine, irinotecan, and oxaliplatin. The combination has been studied primarily as hepatic arterial infusion (HAI) therapy for patients with unresectable liver metastases from colorectal cancer. - **Floxuridine** is a pyrimidine analog that inhibits thymidylate synthase, leading to impaired DNA synthesis and cell death. - **Irinotecan** is a topoisomerase I inhibitor that prevents DNA unwinding and replication by stabilizing the cleavable complex between topoisomerase I and DNA, resulting in double-strand breaks during replication. - **Oxaliplatin** is a platinum-based agent that forms both interstrand and intrastrand crosslinks in DNA, disrupting its function and triggering apoptosis[1][7][9]. The triple-drug regimen delivered via HAI has demonstrated efficacy as first-line treatment for unresectable liver metastases of colorectal cancer, with an overall response rate above 60% in clinical studies[1]. Toxicities include neutropenia, diarrhea, hepatotoxicity (elevated bilirubin/transaminases), vomiting, among others.