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FOLFOXIRI + bevacizumab is a combination chemotherapy and targeted therapy regimen used primarily as first-line treatment for metastatic colorectal cancer. The regimen consists of four chemotherapeutic agents—5-fluorouracil (a pyrimidine analog antimetabolite), folinic acid (leucovorin, which enhances the effect of 5-FU), oxaliplatin (a platinum-based DNA crosslinker), and irinotecan (a topoisomerase I inhibitor)—combined with bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor A (VEGF-A). Bevacizumab inhibits angiogenesis by blocking VEGF-A, thereby reducing tumor blood supply. This combination has demonstrated improved progression-free survival and overall survival compared to doublet regimens plus bevacizumab in phase III trials. The regimen is associated with increased response rates but also higher rates of grade 3/4 toxicities such as neutropenia and diarrhea[1][6][3].
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