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mFOLFIRI is a modified chemotherapy regimen consisting of leucovorin (folinic acid), fluorouracil (5-FU), and irinotecan. It is a variation of the standard FOLFIRI regimen, typically modified by omitting the bolus dose of fluorouracil to improve the safety profile and reduce hematologic toxicities such as neutropenia. mFOLFIRI is widely utilized in the treatment of gastrointestinal cancers, most notably metastatic colorectal cancer, where it serves as a standard-of-care backbone. Its mechanism involves the inhibition of topoisomerase I by irinotecan and the inhibition of thymidylate synthase by fluorouracil, with leucovorin acting as a biochemical modulator to enhance the efficacy of fluorouracil.
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