FOLFOX

FOLFOX is a chemotherapy regimen for treatment of colorectal cancer, made up of the drugs

FOLFOX4

Adjuvant treatment in patients with stage III colon cancer is recommended for 12 cycles, every 2 weeks. The recommended dose schedule given every two weeks is as follows:

Day 1: Oxaliplatin 85 mg/m² IV infusion in 250-500 mL D5W and leucovorin 200 mg/m² IV infusion in D5W both given over 120 minutes at the same time in separate bags using a Y-line, followed by 5-FU 400 mg/m² IV bolus given over 2–4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.

Day 2: Leucovorin 200 mg/m² IV infusion over 120 minutes, followed by 5-FU 400 mg/m² IV bolus given over 2–4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.

FOLFOX4 regime[2][3]
FOLFOX4
drug dose administration time term
Oxaliplatin 85 mg/m² IV infusion 2 h day 1
Folinic acid 200 mg/m² IV infusion 2 h day 1 + 2
Fluorouracil 400 mg/m² IV bolus 2 min day 1 + 2
Fluorouracil 600 mg/m² IV infusion 22 h day 1 + 2

Premedication with antiemetics, including 5-HT3 blockers with or without dexamethasone, is recommended.

FOLFOX6

The dose schedule given every two weeks is as follows:[4]

Day 1–2: Oxaliplatin 100 mg/m² IV infusion, given as a 120 minutes IV infusion in 500 mL D5W, concurrent with leucovorin 400 mg/m² (or levoleucovorin 200 mg/m²) IV infusion, followed by 5-FU 400 mg/m² IV bolus, followed by 46-hour 5-FU infusion (2400 mg/m² for first two cycles, increased to 3000 mg/m² in case of no toxicity > grade 1 during the first two cycles).

Days 3–14: Rest days

Antiemetic prophylaxis with 5-HT3-receptor antagonist.

See also

References

  1. ↑ Cancer Research UK, CancerHelp UK
  2. ↑ de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, Boni C, Cortes-Funes H, Cervantes A, Freyer G, Papamichael D, Le Bail N, Louvet C, Hendler D, de Braud F, Wilson C, Morvan F, Bonetti A (2000). "Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer". J Clin Oncol 18 (16): 2938–47. PMID 10944126. HTML PDF Patients with advanced colorectal cancer were given 5-fluorouracil and leukovorin. Those who were also given oxaliplatin were more likely to have a response, and had longer progression-free survival, than patients without oxaliplatin. However, patients with oxaliplatin didn't survive any longer than patients without it.
  3. ↑ FDA Approval: Eloxatin [oxaliplatin] PDF
  4. ↑ Tournigand, Christophe; André, Thierry; Achille, Emmanuel; Lledo, Gérard; Flesh, Michel; Mery-Mignard, Dominique; Quinaux, Emmanuel; Couteau, Corinne; Buyse, Marc (2004). "FOLFIRI Followed by FOLFOX6 or the Reverse Sequence in Advanced Colorectal Cancer: A Randomized GERCOR Study". Journal of Clinical Oncology 22 (2): 229–237. doi:10.1200/JCO.2004.05.113. ISSN 0732-183X. PMID 14657227.


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