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This is a **combination chemotherapy regimen** composed of five agents: **folinic acid (leucovorin or calcium folinate), fluorouracil (5FU), oxaliplatin, irinotecan, and fuquinitinib**. The first four agents (collectively known as FOLFOXIRI) are a well-established combination for the treatment of advanced or metastatic colorectal cancer, acting via multiple cytotoxic mechanisms to inhibit DNA synthesis and promote apoptosis in rapidly dividing tumor cells[2][3][4]. Folinic acid enhances the cytotoxicity of fluorouracil. Fuquinitinib is a novel vascular endothelial growth factor receptor (VEGFR) inhibitor, which works as an antiangiogenic targeted therapy; adding it to cytotoxic chemotherapy is being explored in clinical development, primarily for gastrointestinal cancers, including colorectal cancer. The combination aims to maximize antitumor efficacy by combining cytotoxic, antimetabolic, DNA-damaging, topoisomerase-inhibiting, and antiangiogenic effects.
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