Cancers & treatments·Regimen libraryFirst line

FOLFIRINOX

Checked 2026-09-09

Metastatic pancreatic cancer, performance status 0-1

One cycle

every 14 days × 12 · about 24 weeks in total

14-day cycle × 12 (6 months) or until progression (about 24 weeks)Intravenous Continuous infusion

Components

Drug	Dose	Route	Days	Note
Oxaliplatin Third-generation platinum (DACH-platinum)	85 mg/m²	IV	D1
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

12 (6 months) or until progression

14-day cycle

Emetogenicity

Moderate (30-90%)

G-CSF

Consider (10-20% FN risk)

Notes

Grade 3-4 neutropenia 45.7% in PRODIGE 4 without mandated G-CSF; many centres give primary prophylaxis or use the modified regimen below.
Often classified as high emetogenic risk in practice because two moderate-risk agents are combined.

Used in

Pancreatic ductal adenocarcinoma

Products

FOLFIRINOX / mFOLFIRINOXOxaliplatinIrinotecan (and liposomal irinotecan)Fluorouracil (5-FU)

Source

PRODIGE 4 / ACCORD 11, NEJM 2011

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.