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L-folinic acid
L-folinic acid is a reduced form of folic acid that acts as a methyl donor and cofactor in one-carbon transfer reactions essential for DNA synthesis and cell division.
L-folinic acid is a reduced form of folic acid that acts as a methyl donor and cofactor in one-carbon transfer reactions essential for DNA synthesis and cell division. Used for Methotrexate toxicity rescue, Adjunct to fluorouracil-based chemotherapy in colorectal cancer and other malignancies.
At a glance
| Generic name | L-folinic acid |
|---|---|
| Also known as | Folinic acid, LFA, ELVORIN |
| Sponsor | The Christie NHS Foundation Trust |
| Drug class | Reduced folate cofactor / Chemotherapy adjuvant |
| Target | Thymidylate synthase (indirect), one-carbon metabolism |
| Modality | Small molecule |
| Therapeutic area | Oncology |
| Phase | Phase 3 |
Mechanism of action
L-folinic acid (leucovorin) is the active form of folic acid that bypasses the need for dihydrofolate reductase conversion, making it immediately available for one-carbon metabolism. It is commonly used as a rescue agent to mitigate toxicity from methotrexate and other antifolate drugs, and as an adjunct to fluorouracil-based chemotherapy to enhance efficacy by stabilizing the ternary complex of thymidylate synthase.
Approved indications
- Methotrexate toxicity rescue
- Adjunct to fluorouracil-based chemotherapy in colorectal cancer and other malignancies
Common side effects
- Allergic reactions
- Gastrointestinal disturbances
- Thrombocytosis
Key clinical trials
- Testing the Addition of the Anti-cancer Drug Venetoclax and/or the Anti-cancer Immunotherapy Blinatumomab to the Usual Chemotherapy Treatment for Infants With Newly Diagnosed KMT2A-rearranged or KMT2A-non-rearranged Leukemia (PHASE2)
- A Study to Investigate Blinatumomab in Combination With Chemotherapy in Patients With Newly Diagnosed B-Lymphoblastic Leukemia (PHASE3)
- Neoadjuvant mFolfirinox With or Without Preoperative Concomitant Chemoradiotherapy in Patients With Borderline Resectable Pancreatic Carcinoma (PANDAS-PRODIGE 44) (PHASE2)
- Targeted Therapy Directed by Genetic Testing in Treating Patients With Locally Advanced or Advanced Solid Tumors, The ComboMATCH Screening Trial (PHASE2)
- Studying Chemotherapy With or Without Panitumumab for Unresectable, Locally Advanced, or Metastatic Pancreatic Cancer Without KRAS Mutations (PHASE3)
- Testing the Addition of Atezolizumab to Combination Chemotherapy or Atezolizumab Alone for Metastatic Colon or Rectal Cancer, the COMMIT Study (PHASE3)
- Study of Chemotherapy, With or Without Binimetinib in Advanced Biliary Tract Cancers in 2nd Line Setting (A ComboMATCH Treatment Trial) (PHASE2)
- Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia (PHASE2)
Primary sources
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| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |