FOLFIRI

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FOLFIRI is a chemotherapy regimen for treatment of colorectal cancer. It is made up of the following drugs:[1]

  • 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.

Medical uses[edit]

FOLFIRI is used for colorectal cancer and gastric cancer.[2] FOLFIRI is effective in the treatment of metastatic colorectal cancer, but it has not been shown to be effective in the adjuvant therapy of colon and rectal cancer.

Regimen[edit]

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.

Combinations[edit]

FOLFIRI is often[citation needed] combined with bevacizumab, aflibercept, cetuximab or panitumumab to improve efficacy and response rate.[3]

Adverse effects[edit]

In the short term, irinotecan causes diarrhea, which may be acute or delayed in onset. Long term use[citation needed] of irinotecan may lead to neutropenia.[4]

See also[edit]

References[edit]

  1. ^ Chen, K; Gong, Y; Zhang, Q; Shen, Y; Zhou, T (2016). "Efficacy and safety of addition of bevacizumab to FOLFIRI or irinotecan/bolus 5-FU/LV (IFL) in patients with metastatic colorectal cancer: A meta-analysis". Medicine. 95 (46): e5221. doi:10.1097/MD.0000000000005221. PMC 5120901Freely accessible. PMID 27861344. 
  2. ^ 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. 22 (2): 229–37. doi:10.1200/jco.2004.05.113. PMID 14657227. 
  3. ^ Kirstein, M. M.; Lange, A.; Prenzler, A.; Manns, M. P.; Kubicka, S.; Vogel, A. (2014). "Targeted Therapies in Metastatic Colorectal Cancer: A Systematic Review and Assessment of Currently Available Data". The Oncologist. 19 (11): 1156. doi:10.1634/theoncologist.2014-0032. PMID 25326159. 
  4. ^ "Onivyde: EPAR – Product Information" (PDF). European Medicines Agency. 25 October 2016.