FOLFOX

The FOLFOX4 regimen is a standard therapy scheme ( EbM Level II) in adjuvant or palliative chemotherapy for the treatment of colorectal cancer in UICC stage III.

Scheme

The therapy is carried out 14 days in twelve cycles according to the following scheme:

FOLFOX4 Active ingredient dose application Duration Therapy day Oxaliplatin 85 mg / m² iv infusion 2 h 1 Folinic acid 200 mg / m² iv infusion 2 h 1 + 2 5-fluorouracil 400 mg / m² iv bolus 2 min 1 + 2 5-fluorouracil 600 mg / m² iv infusion 22 h 1 + 2 (mg / m² = amount / body surface / day)

There is also a variant (“CapeOx”) of FOLFOX4 with capecitabine, the oral prodrug of 5-FU. This therapy is carried out every three and not two weeks.

CapeOx Active ingredient dose application Duration Therapy day Oxaliplatin 130 mg / m² iv infusion 2 h † 1 Capecitabine 1000 mg / m² po 2 × daily 1 - 14 † or longer, according to tolerance (mg / m² = amount / body surface / day)

Comments on therapy

In principle, the FOLFOX4 therapy is an outpatient or inpatient therapy, ie the patient does not always have to be admitted to the hospital as an inpatient. A prerequisite is the prior implantation of a port catheter , via which the 5-FU continuous infusion can then take place.

The FOLFOX scheme can be used in both adjuvant and palliative settings. Under certain conditions, it can be administered in combination with monoclonal antibodies (e.g. bevacizumab or cetuximab ) in the palliative situation .

Since the application can lead to nausea , an antiemetic from the group of 5-HT ₃ receptor inhibitors and dexamethasone should always be given.

See also

• Cytostatic
• FOLFIRI

Web links

• https://www.onkopedia.com/de/onkopedia/guidelines/kolonkarzinom/@@view/html/index.html

Individual evidence

1. ↑ de Gramont, A. et al. (2000): Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer . In: J. Clin. Oncol. Vol. 18, pp. 2938-2947. PMID 10944126 HTML ( Memento of the original from March 31, 2006 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. PDF  ( page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.   
2. ↑ FDA Approval: Eloxatin ^® PDF
3. ↑ Colon Cancer - Onkopedia. Retrieved June 21, 2019 . 

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