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**ramucirumab + FOLFOX4** is a combination regimen consisting of **ramucirumab**, a monoclonal antibody targeting vascular endothelial growth factor receptor 2 (VEGFR-2), and **FOLFOX4**, a chemotherapy regimen composed of oxaliplatin, folinic acid (leucovorin), and fluorouracil (5-FU)[1][2][3]. Ramucirumab inhibits angiogenesis by blocking activation of VEGFR-2, decreasing tumor vascularization. FOLFOX4 acts through a cytotoxic effect, impairing DNA synthesis and function in rapidly dividing cells. This combination is studied as first-line therapy for advanced hepatocellular carcinoma; its tolerability is limited, but preliminary efficacy supports further investigation, with dose modification and careful patient selection recommended[1][3].
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