TAS-102 + oxaliplatin + irinotecan + bevacizumab

This is a multi-agent chemotherapy regimen combining four drugs: **TAS-102 (trifluridine/tipiracil)** is an oral antimetabolite composed of a thymidine-based nucleoside analog (trifluridine) and a thymidine phosphorylase inhibitor (tipiracil). It disrupts DNA synthesis in tumor cells. **Oxaliplatin** is a platinum-based chemotherapeutic that forms DNA crosslinks, inhibiting DNA replication and transcription. **Irinotecan** is a topoisomerase I inhibitor that prevents DNA unwinding necessary for replication. **Bevacizumab** is a monoclonal antibody targeting vascular endothelial growth factor A (VEGF-A), inhibiting angiogenesis required for tumor growth. This combination has been studied primarily in metastatic colorectal cancer patients who have progressed after standard therapies including fluoropyrimidines, oxaliplatin, irinotecan, anti-EGFR agents, and antiangiogenic therapy[1][2][6][10]. The rationale for the combination leverages non-overlapping mechanisms of action to overcome resistance seen with prior lines of therapy.

Other names

trifluridine and tipiracil plus oxaliplatin, irinotecan, and bevacizumab