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oxaliplatin + 5-fluorouracil + levoleucovorin is a systemic combination chemotherapy regimen used in the treatment of advanced colorectal cancers, including colorectal peritoneal carcinomatosis. This specific combination, often referred to as a FOLFOX-type regimen (utilizing the L-isomer levoleucovorin, also known as isovorin), was evaluated by Uppsala University in a Phase 3 clinical trial comparing systemic chemotherapy against cytoreductive surgery (CRS) plus postoperative intraperitoneal chemotherapy. Oxaliplatin is a platinum-based antineoplastic agent that functions by forming inter- and intra-strand DNA cross-links, which inhibit DNA replication and transcription, leading to cell death. 5-fluorouracil (5-FU) is a pyrimidine analogue antimetabolite that primarily inhibits thymidylate synthase, thereby disrupting DNA synthesis. Levoleucovorin is the pharmacologically active isomer of folinic acid; it acts as a biochemical modulator that stabilizes the binding of 5-FU to thymidylate synthase, significantly enhancing the cytotoxic efficacy of the 5-FU component.
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