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NALIRIFOX + targeted therapy is an investigational combination chemotherapy regimen being evaluated as a first-line treatment for patients with metastatic colorectal cancer (mCRC). The regimen is composed of the NALIRIFOX backbone—which includes liposomal irinotecan (Onivyde), oxaliplatin, 5-fluorouracil (5-FU), and leucovorin—combined with a targeted biological agent. The targeted therapy component typically consists of either bevacizumab (an anti-VEGF monoclonal antibody) or cetuximab (an anti-EGFR monoclonal antibody), selected based on the patient's molecular profile, such as RAS mutation status. This combination aims to leverage the improved pharmacokinetic profile of liposomal irinotecan and the synergistic effects of multi-agent cytotoxic therapy with targeted inhibition of angiogenesis or epidermal growth factor signaling to improve clinical outcomes in the first-line mCRC setting.
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