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FOLFIRINOX is a combination chemotherapy regimen consisting of four drugs: fluorouracil (5-FU), irinotecan, leucovorin (folinic acid), and oxaliplatin. It is primarily used as a first-line treatment for advanced or metastatic pancreatic adenocarcinoma in patients with good performance status. The regimen may also be used in the adjuvant or neoadjuvant setting for pancreatic cancer and has been studied in colorectal cancer. - **Mechanism of Action:** - Fluorouracil is an antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis. - Irinotecan is a topoisomerase I inhibitor that prevents DNA unwinding and replication. - Leucovorin enhances the binding of fluorouracil to thymidylate synthase, increasing its efficacy. - Oxaliplatin forms platinum-DNA adducts leading to apoptosis by inhibiting DNA replication and transcription. The combination targets multiple pathways involved in tumor cell proliferation and survival[1][2][3][4][7].
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