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FOLFOX and FOLFIRI are standard-of-care chemotherapy regimens for colorectal cancer. This specific implementation by China Medical University in trial NCT05797883 utilizes Zuoyu, a brand of levofolinic acid (the active L-isomer of folinic acid), as a biochemical modulator. FOLFOX consists of oxaliplatin, 5-fluorouracil (5-FU), and levofolinic acid, while FOLFIRI consists of irinotecan, 5-FU, and levofolinic acid. These regimens work by inhibiting DNA synthesis and inducing DNA damage. 5-FU is an antimetabolite that inhibits thymidylate synthase, a process enhanced by levofolinic acid. Oxaliplatin is a platinum agent that forms DNA adducts, and irinotecan is a topoisomerase I inhibitor that prevents DNA religation. The trial evaluates these regimens with or without targeted agents like cetuximab or bevacizumab for the first-line treatment of unresectable or metastatic colorectal cancer.
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