FOLFIRINOX is a chemotherapy regimen for treatment of advanced pancreatic cancer. It is made up of the following four drugs: FOL – folinic acid (leucovorin), ...FOLFIRINOXFromWikipedia,thefreeencyclopediaJumptonavigationJumptosearchFOLFIRINOXisachemotherapyregimenfortreatmentofadvancedpancreaticcancer.Itismadeupofthefollowingfourdrugs:FOL–folinicacid(leucovorin),avitaminBderivativethatenhancestheeffectsof5-fluorouracil(5-FU);[1][2]F–fluorouracil(5-FU),apyrimidineanalogandantimetabolitewhichincorporatesintotheDNAmoleculeandstopsDNAsynthesis;IRIN–irinotecan(Camptosar),atopoisomeraseinhibitor,whichpreventsDNAfromuncoilingandduplicating;andOX–oxaliplatin(Eloxatin),aplatinum-basedantineoplasticagent,whichinhibitsDNArepairand/orDNAsynthesis.Theregimenemergedin2010asanewtreatmentforpatientswithmetastaticpancreaticcancer.[3][4][5]A2011studypublishedintheNewEnglandJournalofMedicinefoundthatFOLFIRINOXproducedthelongestimprovementinsurvivaleverseeninaphaseIIIclinicaltrialofpatientswithadvancedpancreaticcancer,withpatientsontheFOLFIRINOXtreatmentlivingapproximatelyfourmonthslongerthanpatientsreceivingthestandardgemcitabinetreatment(11.1monthscomparedwith6.8months).[6][7]However,FOLFIRINOXisapotentiallyhighlytoxiccombinationofdrugswithserioussideeffects,andonlypatientswithgoodperformancestatusarecandidatesfortheregimen.[6][8]CurrentlyFOLFIRINOXisbeingusedtodownstagepatientswithadvanceddiseasewiththehopeofrenderingtheirtumorsamenabletosurgicalresection.[9]In2013,theU.S.FoodandDrugAdministrationapprovedprotein-boundpaclitaxel(alsoknownasnab-paclitaxel,soldasAbraxane)usedwithgemcitabine.Thisregimenmaybelesstoxic—butperhapslesseffective—alternativetoFOLFIRINOXfortreatinglate-stagepancreaticcancer.Differencesinthetrials,andthelackofadirecttrialcomparingthetworegimens,precludeafinalconclusion.[8]IntheUnitedKingdom,theNationalInstituteforHealthandCareExcellence(NICE),inadraftguidanceissuedin2014,rejectedthattreatmentduetoconcernsofsideeffects,efficacy,andcostrelativetoGemzar(gemcitabin