NALIRIFOX Plus Targeted Therapy Versus FOLFOX Plus Targeted Therapy as First-line Treatment for Metastatic Colorectal Cancer

This study compares two chemotherapy regimens — NALIRIFOX (a newer combination including liposomal irinotecan) and FOLFOX (a standard combination) — each paired with targeted therapy, as first-line treatment for people with metastatic (spread) colorectal cancer. **You may be eligible if...** - You are 18 or older - You have a confirmed diagnosis of inoperable metastatic colorectal cancer (adenocarcinoma) - You have not yet received any systemic treatment for your metastatic disease - If you had prior neoadjuvant/adjuvant therapy, your disease must have progressed at least 12 months after that treatment ended - You have at least one measurable tumor on imaging (per RECIST 1.1 criteria) - Your physical performance status is ECOG 0 or 1 (fully active or mildly restricted) **You may NOT be eligible if...** - You have already received systemic therapy for your metastatic disease - Your performance status is too poor (ECOG 2 or above) - Your bone marrow, organ function, or other lab values do not meet requirements Talk to your doctor to see if this trial is right for you.