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OXAFI is a neoadjuvant chemoimmunotherapy regimen developed by the National Cancer Centre, Singapore, specifically for the treatment of unresectable, non-metastatic hepatocellular carcinoma (HCC). The regimen is a combination of four agents: oxaliplatin (a platinum-based small molecule that forms DNA adducts), doxorubicin (an anthracycline that inhibits topoisomerase II), fluorouracil (a pyrimidine analog antimetabolite), and interferon alfa-2b (a biologic cytokine with immunomodulatory and antiproliferative properties). The treatment protocol involves a 28-day cycle where oxaliplatin and doxorubicin are administered intravenously on days 1, 8, and 15, fluorouracil is given via continuous intravenous infusion, and interferon alfa-2b is administered subcutaneously three times per week. The primary goal of the OXAFI regimen is to downstage locally advanced tumors to facilitate curative surgical resection or liver transplantation.
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