FOLFOX

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Overview

FOLFOX is a chemotherapy regimen for treatment of colorectal cancer, made up of the drugs

FOLFOX4

Adjuvant treatment in patients with stage III colon cancer is recommended for 12 cycles, every 2 weeks. The recommended dose schedule given every two weeks is as follows:

Day 1: Eloxatin® 85 mg/m² IV infusion in 250-500 mL D5W and leucovorin 200 mg/m² IV infusion in D5W both given over 120 minutes at the same time in separate bags using a Y-line, followed by 5-FU 400 mg/m² IV bolus given over 2-4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.

Day 2: Leucovorin 200 mg/m² IV infusion over 120 minutes, followed by 5-FU 400 mg/m² IV bolus given over 2-4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.

File:FOLFOX4.PNG
FOLFOX4 regime[2][3]
FOLFOX4
drug dose administration time term
Oxaliplatin 85 mg/m² IV infusion 2 h day 1
Folinic acid 200 mg/m² IV infusion 2 h day 1 + 2
Fluorouracil 400 mg/m² IV bolus 2 min day 1 + 2
Fluorouracil 600 mg/m² IV infusion 22 h day 1 + 2


Premedication with antiemetics, including 5-HT3 blockers with or without dexamethasone, is recommended.

References

  1. Cancer Research UK, CancerHelp UK
  2. de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, Boni C, Cortes-Funes H, Cervantes A, Freyer G, Papamichael D, Le Bail N, Louvet C, Hendler D, de Braud F, Wilson C, Morvan F, Bonetti A (2000). "Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer". J Clin Oncol. 18 (16): 2938–47. PMID 10944126.  HTML PDFPatients with advanced colorectal cancer were given 5-fluorouracil and leukovorin. Those who were also given oxaliplatin were more likely to have a response, and had longer progression-free survival, than patients without oxaliplatin. However, patients with oxaliplatin didn't survive any longer than patients without it.
  3. FDA Approval: Eloxatin [oxaliplatin] PDF
  • Goldberg R, Sargent D, Morton R, Fuchs C, Ramanathan R, Williamson S, Findlay B, Pitot H, Alberts S (2004). "A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer". J Clin Oncol. 22 (1): 23–30. PMID 14665611. 

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