leucovorin + 5-fluorouracil + cisplatin

The combination of leucovorin, 5-fluorouracil (5-FU), and cisplatin is a chemotherapy regimen used primarily for treating various types of cancer, particularly head and neck cancer and gastric cancer. This three-drug combination has shown significant activity in both newly diagnosed and recurrent cases. ## Mechanism of Action This regimen combines three drugs with complementary mechanisms: - **Leucovorin** (folinic acid) is not directly cytotoxic but enhances the efficacy of 5-fluorouracil by stabilizing the binding of 5-FU to its target enzyme, thereby increasing its cytotoxic effects. - **5-Fluorouracil (5-FU)** is a pyrimidine analog that inhibits nucleic acid synthesis in rapidly dividing cells, particularly cancer cells. - **Cisplatin** is a platinum-based compound that forms DNA crosslinks, preventing DNA replication and transcription, ultimately leading to cell death. ## Clinical Applications This combination has demonstrated efficacy in: - **Head and Neck Cancer**: Particularly effective in recurrent disease, including in patients who previously received cisplatin and 5-FU as induction chemotherapy. - **Gastric Cancer**: Used in advanced gastric cancer with promising response rates. ## Dosing Regimen The typical dosing regimen involves: - Cisplatin: 80-100 mg/m² on day 1 - 5-FU: 600-1000 mg/m²/day as continuous infusion for 5 days - Leucovorin: 20-50 mg/m² administered at various intervals throughout treatment The maximally tolerated dose of 5-FU in combination with leucovorin and cisplatin has been established at 800 mg/m²/day in some studies. ## Toxicity Profile Common adverse effects include: - Mucositis (particularly in previously irradiated fields) - Myelosuppression - Neutropenia - Gastrointestinal toxicities The dose-limiting toxicity is typically mucositis in previously irradiated sites.

Other names

5-fluorouracil + leucovorin + cisplatincisplatin + 5-fluorouracil + leucovorin