nivolumab + oxaliplatin + leucovorin + fluorouracil + bevacizumab

This combination is composed of five agents: **nivolumab** (a programmed death-1 immune checkpoint inhibitor), **oxaliplatin** (a platinum-based chemotherapy), **leucovorin** (folinic acid that potentiates fluorouracil), **fluorouracil** (a pyrimidine antimetabolite chemotherapy), and **bevacizumab** (a monoclonal antibody targeting vascular endothelial growth factor A). Nivolumab acts by blocking PD-1, thereby restoring T-cell antitumor responses. Oxaliplatin, leucovorin, and fluorouracil together (in "FOLFOX" regimens) interfere with DNA synthesis and replication in tumor cells, while bevacizumab inhibits tumor angiogenesis by binding VEGF-A. This combination is being evaluated primarily as a first-line therapy for advanced or metastatic colorectal cancer and is the subject of ongoing clinical investigations, such as the NIVACOR trial[7]. Mechanistically, it combines immunotherapy (nivolumab) with cytotoxic and antiangiogenic therapy, aiming to enhance antitumor activity in microsatellite stable (MSS) and microsatellite instable (MSI) tumors[7].