- FOL – folinic acid (leucovorin), a vitamin B derivative used as a "rescue" drug for high doses of the drug methotrexate, but increases the cytotoxicity of 5-fluorouracil;
- F – fluorouracil (5-FU), a pyrimidine analog and antimetabolite which incorporates into the DNA molecule and stops synthesis; and
- IRI – irinotecan (Camptosar), a topoisomerase inhibitor, which prevents DNA from uncoiling and duplicating.
FOLFIRI is used for colorectal cancer and gastric cancer. FOLFIRI is effective in the treatment of metastatic colorectal cancer, but it has not been shown to be effective in the adjuvant treatment of colon and rectal cancer.
The regimen consists of:
- Irinotecan (180 mg/m² IV over 90 minutes) concurrently with folinic acid (400 mg/m² [or 2 x 250 mg/m²] IV over 120 minutes).
- Followed by fluorouracil (400–500 mg/m² IV bolus) then fluorouracil (2400–3000 mg/m² intravenous infusion over 46 hours).
This cycle is typically repeated every two weeks. The dosages shown above may vary from cycle to cycle.
In the short term, Irinotecan causes diarrhea, which may be acute or delayed in onset. The long term use of Irinotecan may lead to neutropenia.
- Tournigand, C; André, T; Achille, E; Lledo, G; Flesh, M; Mery-Mignard, D; Quinaux, E; Couteau, C; Buyse, M; Ganem, G; Landi, B; Colin, P; Louvet, C; de Gramont, A (Jan 15, 2004). "FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study.". Journal of clinical oncology : official journal of the American Society of Clinical Oncology 22 (2): 229–37. PMID 14657227.
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