oxaliplatin + leucovorin + 5-fluorouracil + irinotecan

This chemotherapy regimen, specifically investigated by the Fox Chase Cancer Center, consists of alternating cycles of FOLFOX (oxaliplatin, leucovorin, and 5-fluorouracil) and FOLFIRI (irinotecan, leucovorin, and 5-fluorouracil). It is designed as a 'FOLFIRINOX-like' approach to treat older patients (aged 65 and above) with newly diagnosed metastatic pancreatic cancer. The rationale for the alternating schedule is to maintain the anti-tumor efficacy of the three active cytotoxic agents—oxaliplatin, irinotecan, and 5-fluorouracil—while minimizing the overlapping toxicities and cumulative side effects (such as severe neuropathy and gastrointestinal distress) often associated with the standard concurrent FOLFIRINOX triplet. Oxaliplatin acts as a platinum-based DNA alkylating agent that forms cross-links to inhibit replication; irinotecan is a topoisomerase I inhibitor that prevents DNA re-ligation; and 5-fluorouracil is an antimetabolite that inhibits thymidylate synthase.

Other names

alternating FOLFOX and FOLFIRIFOLFIRINOX-like regimenFox Chase alternating regimen