FOLFOX

FOLFOX is a widely used combination chemotherapy regimen consisting of three active agents: folinic acid (leucovorin), 5-fluorouracil (5-FU), and oxaliplatin. It is a standard-of-care treatment for various gastrointestinal malignancies, including gastric, gastroesophageal junction, and esophageal adenocarcinomas. The regimen's efficacy stems from the synergistic mechanisms of its components: oxaliplatin is a platinum-based antineoplastic agent that forms inter- and intra-strand DNA crosslinks, inhibiting DNA replication and transcription; 5-fluorouracil is a pyrimidine analog that acts as an antimetabolite to inhibit thymidylate synthase, thereby disrupting DNA synthesis; and folinic acid is administered to stabilize the binding of 5-FU to thymidylate synthase, enhancing its cytotoxic effect. In the context of the CIME trial led by Centre Leon Berard, FOLFOX is utilized as a backbone of the standard-of-care comparator arm, often combined with the PD-1 inhibitor nivolumab, for patients with locally advanced or metastatic MSI-H/dMMR esogastric adenocarcinomas.

Brand names

Eloxatin (oxaliplatin)Adrucil (fluorouracil)

Other names

FOLFOX regimenFOLFOX protocolOxaliplatin + 5-FU + LeucovorinmFOLFOX6mFOLFOX-6mFOLFOX 6FOLFOX4FOLFOX-4FOLFOX 4FOLFOX6FOLFOX-6FOLFOX 6