FOLFIRI
Checked 2026-09-09
Metastatic colorectal first or second line (with bevacizumab, aflibercept, ramucirumab or an anti-EGFR antibody)
One cycle
every 14 daysComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Irinotecan Topoisomerase I inhibitor (camptothecin prodrug) | 180 mg/m² | IV | D1 | |
Leucovorin (folinic acid) | 400 mg/m² | IV | D1 | 2-hour infusion before fluorouracil |
Fluorouracil bolus Fluoropyrimidine antimetabolite | 400 mg/m² | IV | D1 | |
Fluorouracil infusion Fluoropyrimidine antimetabolite | 2,400 mg/m² | IV | D1, 2 (46 h infusion) |
Cycles
until progression
14-day cycle
Emetogenicity
Moderate (30-90%)
G-CSF
Not routine
Notes
- UGT1A1*28 homozygotes have higher neutropenia risk; consider a lower irinotecan start dose.
Used in
Trials
Source
NCCN Colon Cancer; Douillard, Lancet 2000
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.
Other regimens for these cancers
mFOLFOX6
Adjuvant stage III colon (6 months) or metastatic colorectal and upper GI first line
every 14 days × 12
CAPOX
Adjuvant stage III colon (3 or 6 months), rectal total neoadjuvant therapy, metastatic first line
every 21 days × 4
FLOT
Resectable gastric or gastro-oesophageal junction adenocarcinoma, cT2 or higher or node-positive
every 14 days × 4
CROSS chemoradiation
Resectable oesophageal or junctional cancer (T1N1 or T2-3N0-1), before surgery
weekly × 5
Nivolumab + FOLFOX or CAPOX
Unresectable or metastatic HER2-negative gastric, junctional or oesophageal adenocarcinoma, first line (benefit concentrated in PD-L1 CPS 5 or above)
every 14 days
Pembrolizumab + cisplatin + fluorouracil
Advanced oesophageal or Siewert type 1 junctional cancer, first line
every 21 days
Trifluridine/tipiracil + bevacizumab
Refractory metastatic colorectal cancer after two lines
every 28 days
Pembrolizumab monotherapy
Adjuvant melanoma stage IIB-IV (1 year); PD-L1 TPS 50% or above NSCLC; MSI-high tumours; recurrent head and neck (CPS 1 or above)
every 21 days