FOLFOXIRI

FOLFOXIRI is a chemotherapy regimen for treatment of advanced colorectal cancer.[1][2][3][4][5] The role of FOLFOXIRI in colorectal cancer has been reviewed.[1][6]

The chemotherapy regimen is made up of the following four drugs:

• FOL – folinic acid (leucovorin), a vitamin B derivative that modulates/potentiates/reduces the side effects of fluorouracil;
• F – fluorouracil (5-FU), a pyrimidine analog and antimetabolite which incorporates into the DNA molecule and stops DNA synthesis;
• OX – oxaliplatin (Eloxatin), a platinum-based antineoplastic agent, which inhibits DNA repair and/or DNA synthesis;
• IRI – irinotecan (Camptosar), a topoisomerase inhibitor, which prevents DNA from uncoiling and duplicating.

It is usually given with bevacizumab,[7] unlike FOLFIRINOX for treatment of advanced pancreatic cancer. Also, the doses (Day 1: irinotecan 165 mg/m2 IV, plus oxaliplatin 85 mg/m2 IV; Day 1: leucovorin 400 mg/m2; Days 1–3: fluorouracil 1,600 mg/m2/day × 2 days (total 3,200 mg/m2 over 48 hours) continuous infusion starting on day 1; Day 1: bevacizumab 5 mg/kg IV; repeat cycle every 2 weeks)[1][8][9] are slightly dissimilar to FOLFIRINOX.

Upfront FOLFOXIRI with bevacizumab can be followed by fluoropyrimidine with bevacizumab maintenance.[10]