eligibility_summary
Eligible: adults ≥18 with unresectable, synchronous, left‑sided mCRC (adenocarcinoma) RAS/BRAF WT, MSS/pMMR, ≥1 RECIST v1.1 lesion, ECOG 0–1, no prior palliative systemic therapy, relapse >12 mo after adjuvant platinum, adequate labs, no serious primary‑tumor complications. Exclude: initially resectable mCRC, MSI‑H/dMMR, recent oxaliplatin/5‑FU, prior palliative failure, uncontrolled HBV/CNS mets/CV disease, ≥grade 2 neuropathy, GI issues, pregnancy, other cancer ≤5y, other therapy/trial, noncompliance.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase III first-line trial in unresectable left-sided mCRC (RAS/BRAF WT, MSS): mCapOX (capecitabine + oxaliplatin) + cetuximab vs mFOLFOX6 (5‑fluorouracil + leucovorin + oxaliplatin) + cetuximab, maintenance capecitabine ± cetuximab. Drug types/mechanisms: Capecitabine/5‑FU (antimetabolite fluoropyrimidines) inhibit thymidylate synthase and incorporate into RNA/DNA, impairing DNA/RNA synthesis in proliferating tumor cells. Leucovorin (folate analog) enhances 5‑FU’s TS inhibition. Oxaliplatin (platinum alkylating‑like) forms DNA crosslinks, triggering apoptosis. Cetuximab (chimeric IgG1 anti‑EGFR monoclonal antibody) blocks EGFR ligand binding, inhibiting EGFR→RAS‑RAF‑MEK‑ERK and PI3K‑AKT signaling, and mediates ADCC via NK cells. Targets: EGFR‑expressing colorectal cancer cells, thymidylate synthase/DNA synthesis, DNA damage pathways, and EGFR signaling.