Fluorouracil and leucovorin (LV5FU2)
Checked 2026-09-09
Colorectal cancer when oxaliplatin or irinotecan cannot be given; the fluoropyrimidine backbone of FOLFOX and FOLFIRI
Also called FU-LV, 5-FU/LV, LV5FU2, de Gramont.
One cycle
every 14 days × 12 · about 24 weeks in totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Leucovorin | 200 mg/m² | IV | D1, 2 | |
Fluorouracil bolus Fluoropyrimidine antimetabolite | 400 mg/m² | IV | D1, 2 | |
Fluorouracil infusion Fluoropyrimidine antimetabolite | 600 mg/m² | IV | D1, 2 (22 h infusion) |
Cycles
12 (6 months) adjuvant; until progression advanced
14-day cycle
Emetogenicity
Low (10-30%)
G-CSF
Not routine
Notes
- Capecitabine is the oral equivalent for most patients.
- Test for DPD deficiency before fluoropyrimidines where guidance requires it.
Used in
Products
Source
de Gramont, JCO 1997: bimonthly high-dose leucovorin and fluorouracil (LV5FU2)
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
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every 21 days × 4
FOLFIRI
Metastatic colorectal first or second line (with bevacizumab, aflibercept, ramucirumab or an anti-EGFR antibody)
every 14 days
Trifluridine/tipiracil + bevacizumab
Refractory metastatic colorectal cancer after two lines
every 28 days
Pembrolizumab monotherapy
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every 21 days
Modified XELIRI
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every 21 days