FOLFOX (5-FU, leucovorin, oxaliplatin)
FOLFOX is the workhorse chemotherapy combination for bowel cancer, used after surgery to cure and in advanced disease as the backbone that targeted drugs are added to.
Infusional 5-fluorouracil with leucovorin plus oxaliplatin every 2 weeks. MOSAIC (2004) established it as adjuvant therapy for stage III colon cancer; IDEA (2018) showed 3 months suffices for low-risk stage III with CAPOX. In mCRC it pairs with bevacizumab, cetuximab/panitumumab, encorafenib + cetuximab (BREAKWATER), or tucatinib + trastuzumab (MOUNTAINEER-03). Cumulative oxaliplatin neuropathy is the limiting toxicity.
1.Oxaliplatin crosslinks DNA so it cannot be copied
- Route
- Intravenous
- Schedule
- Oxaliplatin 85 mg/m² + leucovorin 400 mg/m² day 1, 5-FU 400 mg/m² bolus then 2,400 mg/m² over 46 h, every 14 days
- Dose modifications
- Stop or reduce oxaliplatin for persistent grade 2 neuropathy; DPD deficiency testing before 5-FU is recommended in Europe
- Monitoring
- Blood counts, neuropathy, liver function
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2004 | Adjuvant stage III colon cancer (oxaliplatin, MOSAIC) |
| Adverse event |
|---|
| Peripheral sensory neuropathy Cumulative, often persistent; oxaliplatin |
| Neutropenia |
| Diarrhoea, mucositis |
| Cold-induced dysaesthesia Acute, oxaliplatin |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Landmark trials in OnCo
Latest papers
topQuery for this drug: (TITLE:"FOLFOX" OR ABSTRACT:"FOLFOX" OR TITLE:"5-FU, leucovorin, oxaliplatin" OR ABSTRACT:"5-FU, leucovorin, oxaliplatin" OR TITLE:"mFOLFOX6" OR ABSTRACT:"mFOLFOX6") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about FOLFOX (5-FU, leucovorin, oxaliplatin), not a curated reading list.
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