5-fluorouracil + oxaliplatin + irinotecan

5-fluorouracil + oxaliplatin + irinotecan (FOLFIRINOX or modified FOLFIRINOX) is a multi-agent chemotherapy combination regimen consisting of three small-molecule cytotoxic agents. It is widely utilized in the treatment of gastrointestinal malignancies, particularly pancreatic and colorectal cancers. The regimen functions through three complementary mechanisms: 5-fluorouracil acts as a pyrimidine analog antimetabolite that inhibits thymidylate synthase; oxaliplatin is a platinum-based agent that forms DNA cross-links; and irinotecan serves as a topoisomerase I inhibitor. The combination is typically administered alongside leucovorin, which acts as a biochemical modulator to enhance the efficacy of 5-fluorouracil. In clinical research, such as the ISANOX trial (NCT05868317) conducted by the Salah Azaïz Cancer Institute, the regimen is being evaluated as part of a total neoadjuvant treatment (TNT) strategy for locally advanced rectal cancer.

Other names

5-FU + oxaliplatin + irinotecan