What is the correct sequence for infusing FOLFIRINOX? —Helen Yung, BSN

FOLFIRINOX regimen involves four drugs: oxaliplatin (Eloxatin, generics), leucovorin (Fusilev, generics), irinotecan (Camptosar, generics), and fluorouracil. The regimen sequence is as follows:


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• Oxaliplatin 85 mg/m2 IV over 2 hours (total dose/cycle, 85 mg/m2)

• Leucovorin 400 mg/m2 IV over 2 hours (total dose/cycle, 400 mg/m2)

• Irinotecan 180 mg/m2 IV over 90 minutes (total dose/cycle, 180 mg/m2)

• Fluorouracil 400 mg/m2 IV bolus; followed by 2,400 mg/m2 IV continuous infusion (CI) over 46 hours beginning on Day 1 (total dose/cycle [bolus and CI], 2,800 mg/m2)

Repeat this cycle every 14 days until disease progression or unacceptable toxicity. Recommended course is 12 cycles. —Abimbola Farinde, PharmD, MS, BCPP, CGP, LCDC, PM/PRC, FASCP, FACA, FNAP, Rsci, ARSPharmS