FOLFOXIRI explained

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

Notes and References

1. Nipp RD, Ryan DP . Should FOLFOXIRI plus bevacizumab Be the standard first-line therapy in metastatic colorectal cancer? . Oncologist . 20 . 3 . 236–8 . 2015 . 25660156 . 4350810 . 10.1634/theoncologist.2014-0495 .
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) http://meetinglibrary.asco.org/content/139397-158
3. Akhtar R, Chandel S, Sarotra P, Medhi B . Current status of pharmacological treatment of colorectal cancer . World J Gastrointest Oncol . 6 . 6 . 177–83 . 2014 . 24936228 . 4058725 . 10.4251/wjgo.v6.i6.177 . free .
4. ESMO. First-Line FOLFOXIRI/Bevacizumab Improves Long-Term Outcomes in Metastatic Colorectal Cancer. Updated survival results of the phase III TRIBE study. http://www.esmo.org/Oncology-News/First-Line-FOLFOXIRI-Bevacizumab-Improves-Long-Term-Outcomes-in-Metastatic-Colorectal-Cancer
5. Cremolini C, Loupakis F, Antoniotti C . 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 . 2015 . 26338525 . 10.1016/S1470-2045(15)00122-9 . etal. 11568/1093304 . free .
6. Stein A, Glockzin G, Wienke A . 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 . 2012 . 22897915 . 3503684 . 10.1186/1471-2407-12-356 . etal . free .
7. Loupakis F, Cremolini C, Masi G . Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer . N. Engl. J. Med. . 371 . 17 . 1609–18 . 2014 . 25337750 . 10.1056/NEJMoa1403108 . etal. free . 11568/759790 . free .
8. Web site: Colon Cancer Treatment Regimens. 2015-01-28.
9. Falcone A, Ricci S, Brunetti I . 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 . 2007 . 17470860 . 10.1200/JCO.2006.09.0928 . etal. free .
10. Stein A, Atanackovic D, Hildebrandt B . 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 . 2015 . 26335608 . 10.1038/bjc.2015.299 . etal. 4578090 .