irinotecan + S-1 + bevacizumab

A multi-agent antineoplastic regimen that combines irinotecan, the oral fluoropyrimidine S-1, and the anti-VEGF monoclonal antibody bevacizumab. Irinotecan is a prodrug converted to SN-38, which inhibits DNA topoisomerase I, leading to DNA damage in proliferating tumor cells. S-1 is an oral formulation containing tegafur (a prodrug of 5-fluorouracil), gimeracil (a dihydropyrimidine dehydrogenase inhibitor that increases 5-FU exposure), and oteracil (which reduces gastrointestinal phosphorylation of 5-FU to limit GI toxicity), thereby functioning as a fluoropyrimidine antimetabolite. Bevacizumab binds vascular endothelial growth factor A (VEGF-A) to inhibit angiogenesis, normalizing tumor vasculature and enhancing chemotherapy delivery. This combination has been evaluated as first-line and second-line therapy for metastatic colorectal cancer, where randomized phase III data showed noninferior progression-free survival versus oxaliplatin-based bevacizumab regimens, supporting its use as a standard option in mCRC.[3][5][6][1]

Brand names

CamptoCamptosarAvastin

Other names

S-1 and irinotecan plus bevacizumabS1 and irinotecan plus bevacizumabS 1 and irinotecan plus bevacizumabIRIS plus bevacizumab