fluorouracil + leucovorin + oxaliplatin + yttrium-90 microspheres

This is a combination therapy consisting of three chemotherapeutic agents—fluorouracil (5-FU), leucovorin (folinic acid), and oxaliplatin—administered systemically as the FOLFOX regimen, together with selective internal radiation therapy (SIRT) using yttrium-90 resin microspheres. The chemotherapy components act synergistically to inhibit DNA synthesis and repair in rapidly dividing cancer cells. Fluorouracil is a pyrimidine analog that inhibits thymidylate synthase, leading to impaired DNA synthesis; leucovorin enhances the binding of fluorouracil to its target enzyme; oxaliplatin forms DNA crosslinks causing cytotoxicity. Yttrium-90 microspheres are delivered via hepatic arterial infusion directly into liver tumors, providing targeted beta-emitting radiotherapy that induces tumor cell death through localized radiation damage. This combined modality is primarily investigated for patients with unresectable liver metastases from colorectal cancer and aims to maximize local tumor control while leveraging systemic chemotherapy’s radiosensitizing effects[1][2][3][4][5].

Brand names

SIR-Spheres

Other names

FOLFOX plus Y-90 radioembolizationFOLFOX plus SIRTFOLFOX4 with Yttrium-90FOLFOX-4 with Yttrium-90FOLFOX 4 with Yttrium-90