Inclusion Criteria:

- Metastatic colorectal adenocarcinoma.

- Measurable disease by RECIST criteria.

- Adequate hepatic function: total bilirubin ≤2.0 x upper limits of normal (ULN);
Aspartate Amino Transferase (AST)/Alanine Amino Transferase (ALT) ≤3.0X upper limits
of normal (or ≤5X upper limits of normal if attributable to liver metastases).

- Adequate renal function: serum creatinine ≤2.0 mg/dl.

- Adequate bone marrow function: absolute neutrophil count ≥1,500/mm3; platelets ≥
100,000/mm3.

- Prothrombin time (PT) and activated partial thromboplastin time (aPTT) levels ≤1.5
upper limit of normal (unless patients receiving coumadin anticoagulation in which
case a stable international normalized ratio (INR) of 2-3 is required).

- Age ≥ 18 years.

- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.

- Life expectancy ≥ 12 weeks.

- Negative pregnancy test.

- Ability to sign informed consent.

Exclusion Criteria:

- Prior systemic chemotherapy for metastatic colorectal cancer

- Prior oxaliplatin in the adjuvant setting within 12 months

- Uncontrolled central nervous system metastases or carcinomatous meningitis.

- Myocardial infarction in the past 6 months.

- Major surgery within 8 weeks prior to enrollment.

- Uncontrolled serious medical or psychiatric illness.

- Inadequately controlled hypertension (defined as systolic blood pressure >160mmHg, or
diastolic blood pressure > 100mmHg).

- Pregnant or lactating women. Both men and women of childbearing potential must be
advised of the importance of using effective birth control measures during the course
of study.

- Prior experimental therapy targeting the IGF-1 pathway

- Concurrent malignancy (with the exception of squamous or basal cell skin carcinoma)

- Planned surgical metastasectomy

- Patient has known hypersensitivity to components of treatment, their analogs, or
drugs of similar chemical or biologic composition