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Oxaliplatin + raltitrexed is a combination chemotherapy regimen, often referred to as TOMOX, used primarily for the treatment of advanced or metastatic colorectal cancer and malignant pleural mesothelioma. Oxaliplatin is a platinum-based chemotherapeutic agent that induces DNA crosslinking and apoptosis in rapidly dividing cells. Raltitrexed is a thymidylate synthase inhibitor that disrupts DNA synthesis by inhibiting the formation of thymidine, an essential nucleotide for DNA replication. The combination has demonstrated efficacy as first-line therapy in patients with advanced colorectal cancer, particularly those intolerant to fluoropyrimidines such as 5-fluorouracil or capecitabine[1][4][5]. It has also shown activity in malignant mesothelioma[2]. The regimen is generally administered intravenously every 21 days and is considered well-tolerated with manageable toxicity profiles including neutropenia, neurotoxicity (from oxaliplatin), asthenia, and gastrointestinal side effects[1][2][3].
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