FOLFIRINOX

FOLFIRINOX is a combination chemotherapy regimen used in the treatment of pancreatic cancer. It is considered one of the most effective treatments for metastatic pancreatic cancer, offering a survival benefit over other chemotherapy regimens. FOLFIRINOX is an acronym that stands for the four drugs included in the regimen: Folinic acid (leucovorin), Fluorouracil (5-FU), Irinotecan, and Oxaliplatin.

Components of FOLFIRINOX

• Folinic acid (Leucovorin): A form of folic acid that enhances the effectiveness of Fluorouracil.
• Fluorouracil (5-FU): An antimetabolite that interferes with the synthesis of DNA and RNA.
• Irinotecan: A topoisomerase inhibitor that prevents DNA from unwinding, which is necessary for DNA replication.
• Oxaliplatin: A platinum-based drug that causes DNA crosslinking and inhibits DNA synthesis.

Mechanism of Action

FOLFIRINOX works by combining the mechanisms of its four components to target and kill rapidly dividing cancer cells. Folinic acid enhances the binding of Fluorouracil to the enzyme thymidylate synthase, increasing its cytotoxic effects. Fluorouracil inhibits thymidylate synthase, leading to a decrease in thymidine production, which is essential for DNA synthesis. Irinotecan inhibits topoisomerase I, preventing DNA replication and transcription. Oxaliplatin forms DNA adducts that disrupt DNA synthesis and transcription.

Indications

FOLFIRINOX is primarily indicated for the treatment of metastatic pancreatic cancer. It is also used in some cases of locally advanced pancreatic cancer and has been studied for use in other types of gastrointestinal cancers.

Side Effects

The regimen is associated with significant side effects, which can include:

• Neutropenia
• Thrombocytopenia
• Anemia
• Diarrhea
• Nausea and vomiting
• Peripheral neuropathy
• Fatigue

Administration

FOLFIRINOX is administered intravenously, typically in a hospital or clinical setting. The treatment cycle usually lasts for two weeks, with the drugs given on specific days within the cycle.

Efficacy

Clinical trials have shown that FOLFIRINOX can significantly improve overall survival and progression-free survival in patients with metastatic pancreatic cancer compared to other chemotherapy regimens such as gemcitabine.

Related Pages

• Pancreatic cancer
• Chemotherapy
• Folinic acid
• Fluorouracil
• Irinotecan
• Oxaliplatin
• Metastatic cancer