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mFOLFOX6 + tivozanib is a combination regimen consisting of the chemotherapy protocol mFOLFOX6 (modified FOLinic acid [leucovorin], Fluorouracil [5-FU], and OXaliplatin) together with tivozanib, an oral small molecule inhibitor of vascular endothelial growth factor receptors (VEGFR)-1, -2, and -3. The combination has been investigated primarily for advanced gastrointestinal cancers, including metastatic colorectal cancer (mCRC). Tivozanib acts as a potent antiangiogenic agent by selectively inhibiting VEGFR tyrosine kinases, thereby blocking tumor angiogenesis. The addition of mFOLFOX6 provides cytotoxic activity against rapidly dividing tumor cells through DNA crosslinking (oxaliplatin), inhibition of thymidylate synthase (fluorouracil), and enhancement of 5-FU efficacy via leucovorin. Clinical studies have shown that this combination demonstrates encouraging antitumor activity with a tolerable safety profile in patients with advanced GI tumors; however, it was not superior to bevacizumab/mFOLFOX6 in phase II trials for previously untreated metastatic colorectal cancer[1][2][4][5].
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