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Neoadjuvant chemotherapy Folfirinox, 4 cycles
FOLFIRINOX is a combination chemotherapy regimen that simultaneously attacks cancer cells through multiple mechanisms: fluorouracil and leucovorin inhibit thymidylate synthase to disrupt DNA synthesis, while irinotecan inhibits topoisomerase I to prevent DNA unwinding.
FOLFIRINOX is a combination chemotherapy regimen that simultaneously attacks cancer cells through multiple mechanisms: fluorouracil and leucovorin inhibit thymidylate synthase to disrupt DNA synthesis, while irinotecan inhibits topoisomerase I to prevent DNA unwinding. Used for Neoadjuvant treatment of locally advanced pancreatic cancer, Metastatic colorectal cancer, Gastric and gastroesophageal junction adenocarcinoma.
At a glance
| Generic name | Neoadjuvant chemotherapy Folfirinox, 4 cycles |
|---|---|
| Sponsor | University Hospital, Bordeaux |
| Drug class | Combination chemotherapy regimen |
| Target | Multiple: thymidylate synthase, topoisomerase I, DNA (cross-linking) |
| Modality | Small molecule |
| Therapeutic area | Oncology |
| Phase | Phase 3 |
Mechanism of action
FOLFIRINOX combines four cytotoxic agents (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) that work synergistically to kill rapidly dividing cancer cells. Fluorouracil and leucovorin disrupt nucleotide synthesis and DNA replication, irinotecan prevents DNA topoisomerase I-mediated DNA unwinding, and oxaliplatin creates DNA cross-links. This multi-agent approach provides broader cytotoxic coverage and is used in the neoadjuvant setting to shrink tumors before surgical resection.
Approved indications
- Neoadjuvant treatment of locally advanced pancreatic cancer
- Metastatic colorectal cancer
- Gastric and gastroesophageal junction adenocarcinoma
Common side effects
- Neutropenia
- Anemia
- Thrombocytopenia
- Diarrhea
- Nausea/vomiting
- Peripheral neuropathy
- Fatigue
- Mucositis
- Febrile neutropenia
Key clinical trials
- Response Adapted Neoadjuvant Therapy in Gastroesophageal Cancers (RANT-GC Trial) (PHASE1)
- Surgical Resection of Synchronous Pulmonary or Hepatic Oligometastatic Pancreatic Ductal Adenocarcinoma (NA)
- Neoadjuvant Triple Therapy for (Borderline) Resectable Pancreatic Cancer (PREOPANC-5) (PHASE1, PHASE2)
- Neo-adjuvant FOLF(IRIN)OX for Resectable Pancreatic Adenocarcinoma (PHASE2)
- NeoOPTIMIZE: Early Switching of mFOLFIRINOX or Gemcitabine/Nab-Paclitaxel Before Surgery for the Treatment of Resectable, Borderline Resectable, or Locally-Advanced Unresectable Pancreatic Cancer (PHASE2)
- 24BRO681 : Alternating Gnp and mFOLFIRINOX for BR-PDAC (PHASE2)
- Neoadjuvant Treatment vs Upfront Surgery for Left-Sided Pancreatic Cancer (PHASE3)
- Adaptive Approach to Neoadjuvant Therapy to Maximize Resection Rates for Pancreatic Adenocarcinoma (PHASE2)
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
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