Dose Escalation and Expansion Clinical Trial of Irinotecan Liposome Combined With Oxaliplatin and 5-FU/LV Plus Bevacizumab as First-line Treatment of Metastatic Colorectal Cancer

This study is testing a combination of four chemotherapy drugs — a liposomal form of irinotecan, oxaliplatin, 5-FU/leucovorin, and bevacizumab — as a first-line treatment for metastatic colorectal cancer (cancer that has spread to other organs). **You may be eligible if...** - You are between 18 and 75 years old - You have metastatic colorectal cancer confirmed by biopsy that cannot be surgically removed - You have not yet received any systemic cancer treatment for your metastatic disease - If you had prior neoadjuvant or adjuvant chemotherapy, it was completed at least 12 months before your disease came back - Your cancer is measurable on imaging - Your overall performance status is excellent (ECOG 0) - Your blood counts, liver, and kidney function are adequate **You may NOT be eligible if...** - You have MSI-H or dMMR cancer and are a candidate for immunotherapy - You have previously received irinotecan - You are underweight (BMI under 18.5) - You have brain metastases - You have had recent major surgery or untreated gastrointestinal problems - You have interstitial lung disease Talk to your doctor to see if this trial is right for you.