gemcitabine + fluorouracil + leucovorin + oxaliplatin

This neoadjuvant combination regimen, evaluated by the University of Nebraska, is designed for the treatment of locally advanced pancreatic cancer. The protocol involves an initial phase of chemotherapy consisting of gemcitabine, fluorouracil (5-FU), and leucovorin (GFL), followed by a second phase of radiation therapy combined with oxaliplatin. Gemcitabine and 5-FU are antimetabolites that disrupt DNA synthesis by inhibiting ribonucleotide reductase and thymidylate synthase, respectively. Leucovorin is administered to enhance the cytotoxic effect of 5-FU by stabilizing its binding to thymidylate synthase. Oxaliplatin, a platinum-based antineoplastic agent, is utilized during the chemoradiation phase to induce DNA cross-linking and act as a radiosensitizer. This multi-modal approach aims to achieve tumor downstaging to facilitate curative-intent surgical resection (R0/R1) in patients previously considered to have unresectable disease.

Other names

GFL-Oxaliplatin regimenNeoadjuvant GFL plus Oxaliplatin-based chemoradiation