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Oxaliplatin and irinotecan are both small molecule chemotherapy agents commonly used in combination regimens for the treatment of metastatic colorectal cancer and other solid tumors. Oxaliplatin is a third-generation platinum-based compound that exerts its cytotoxic effect primarily through DNA crosslinking, leading to inhibition of DNA replication and transcription, which results in cell death. Irinotecan is a topoisomerase I inhibitor that prevents the religation of single-strand breaks induced during DNA replication, causing double-strand breaks and apoptosis. The combination exploits complementary mechanisms to enhance antitumor activity. Both drugs are cell-cycle nonspecific but have distinct toxicity profiles; oxaliplatin is associated with neuropathy while irinotecan can cause diarrhea and myelosuppression[2][4][6].
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