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 165mg/m2 IV, plus oxaliplatin 85mg/m2 IV; Day 1: leucovorin 400mg/m2; Days 1–3: fluorouracil 1,600mg/m2/day × 2 days (total 3,200mg/m2 over 48 hours) continuous infusion starting on day 1; Day 1: bevacizumab 5mg/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)
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.
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. 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. PMID 25337750.
8. http://www.cancertherapyadvisor.com/gastrointestinal-cancers/colon-cancer-treatment-regimens/article/218158/
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. PMID 26335608.