mFOLFIRINOX

mFOLFIRINOX (modified FOLFIRINOX) is a chemotherapy regimen used primarily for the treatment of locally advanced unresectable or metastatic pancreatic adenocarcinoma in patients with good performance status. It is a modification of the standard FOLFIRINOX regimen, which consists of four drugs: leucovorin calcium (folinic acid), fluorouracil, irinotecan hydrochloride, and oxaliplatin. The "modified" version typically involves dose reductions or omission of certain components (such as bolus 5-fluorouracil and reduced doses of irinotecan and oxaliplatin) to improve tolerability while maintaining efficacy[3][5][8]. These agents work synergistically to inhibit DNA synthesis and repair in rapidly dividing cancer cells through different mechanisms: - Fluorouracil is an antimetabolite that incorporates into DNA/RNA and inhibits thymidylate synthase. - Irinotecan inhibits topoisomerase I, preventing DNA uncoiling. - Oxaliplatin forms platinum-DNA adducts that disrupt replication. - Leucovorin enhances the effect of fluorouracil. The regimen has demonstrated improved survival outcomes compared to single-agent therapies but can be associated with significant toxicity; thus, it is reserved for patients who are fit enough to tolerate combination chemotherapy[6][8].

Other names

modified folfirinox