FOLFOXIRI

FOLFOXIRI is a chemotherapy regimen for the 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, 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]

See also

• FOLFIRI
• FOLFOX
• FOLFIRINOX
• IFL

References

1. Nipp RD, Ryan DP (2015). "Should FOLFOXIRI plus bevacizumab Be the standard first-line therapy in metastatic colorectal cancer?". Oncologist. 20 (3): 236–8. doi:10.1634/theoncologist.2014-0495. PMC 4350810. PMID 25660156.
2. FOLFOXIRI plus bevacizumab (bev) versus FOLFIRI plus bev as first-line treatment of metastatic colorectal cancer (mCRC): Updated survival results of the phase III TRIBE trial by the GONO group. J Clin Oncol 33, 2015 (suppl 3; abstr 657) [1]
3. Akhtar R, Chandel S, Sarotra P, Medhi B (2014). "Current status of pharmacological treatment of colorectal cancer". World J Gastrointest Oncol. 6 (6): 177–83. doi:10.4251/wjgo.v6.i6.177. PMC 4058725. PMID 24936228.
4. ESMO. First-Line FOLFOXIRI/Bevacizumab Improves Long-Term Outcomes in Metastatic Colorectal Cancer. Updated survival results of the phase III TRIBE study. [2]
5. Cremolini C, Loupakis F, Antoniotti C, et al. (2015). "FOLFOXIRI plus bevacizumab versus FOLFIRI plus bevacizumab as first-line treatment of patients with metastatic colorectal cancer: updated overall survival and molecular subgroup analyses of the open-label, phase 3 TRIBE study". Lancet Oncol. 16 (13): 1306–15. doi:10.1016/S1470-2045(15)00122-9. hdl:11568/1093304. PMID 26338525.
6. Stein A, Glockzin G, Wienke A, et al. (2012). "Treatment with bevacizumab and FOLFOXIRI in patients with advanced colorectal cancer: presentation of two novel trials (CHARTA and PERIMAX) and review of the literature". BMC Cancer. 12: 356. doi:10.1186/1471-2407-12-356. PMC 3503684. PMID 22897915.
7. Loupakis F, Cremolini C, Masi G, et al. (2014). "Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer". N. Engl. J. Med. 371 (17): 1609–18. doi:10.1056/NEJMoa1403108. hdl:11568/759790. PMID 25337750.
8. "Colon Cancer Treatment Regimens". 2015-01-28.
9. Falcone A, Ricci S, Brunetti I, et al. (2007). "Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest". J. Clin. Oncol. 25 (13): 1670–6. doi:10.1200/JCO.2006.09.0928. PMID 17470860.
10. Stein A, Atanackovic D, Hildebrandt B, et al. (2015). "Upfront FOLFOXIRI plus bevacizumab followed by fluoropyrimidin and bevacizumab maintenance in patients with molecularly unselected metastatic colorectal cancer". Br. J. Cancer. 113 (6): 872–7. doi:10.1038/bjc.2015.299. PMC 4578090. PMID 26335608.