The FOLFIRINOX chemotherapy regimen for the treatment of advanced pancreatic cancer (ductal adenocarcinoma of the pancreas) is a 4-drug combination therapy consisting of leucovorin calcium (folinic acid), fluorouracil (also known as 5-FU), irinotecan hydrochloride, and Oxaliplatin.

Use of this regimen emerged in 2010, and reached critical attention in the May 12, 2011 issue of the New England Journal of Medicine authored by Thierry Conroy, et al. which demonstrated that patients with advanced pancreatic cancer treated with FOLFIRINOX gained a survival advantage of about four months over those patients treated with gemcitabine alone (11.1 months compared to 6.8 months; P ≤ 0.001). The NCCN eventually recommended the FOLFIRINOX regimen as first line treatment for advanced pancreatic cancer.

The survival advantage does come with a price however, in that the side effects of the drugs can be severe. Subsequent research has proceeded with verification of efficacy, but with attempts and reducing or modifying this regimen to try to reduce the harsh side-effect profile.

In the Pancreatica Blog we have addressed this topic and these issues a number of times including Here, Here, Here, and Here.