hyaluronic acid-irinotecan + 5-fluorouracil + leucovorin

**hyaluronic acid-irinotecan + 5-fluorouracil + leucovorin** is a combination regimen consisting of three agents: hyaluronic acid-conjugated irinotecan (a topoisomerase I inhibitor, subject to regional/formulation variations, but sometimes used as a novel delivery platform for irinotecan), 5-fluorouracil (a pyrimidine analogue antimetabolite), and leucovorin (a reduced folate that enhances 5-FU activity). This combination builds on the established regimen of irinotecan + 5-fluorouracil + leucovorin (FOLFIRI), widely used for the treatment of metastatic colorectal cancer. The addition of hyaluronic acid-irinotecan may improve drug delivery and tumor targeting. - **Irinotecan** inhibits topoisomerase I, leading to DNA damage during replication and cell death. - **5-fluorouracil** inhibits thymidylate synthase, disrupting DNA synthesis. - **Leucovorin** potentiates the anticancer activity of 5-fluorouracil by increasing its binding to thymidylate synthase. The standard FOLFIRI regimen is a backbone of first-line chemotherapy for advanced colorectal cancer, and there is clinical research into delivery modifications, such as hyaluronic acid conjugation, to enhance efficacy and reduce toxicity[1][2][5].