Related Experiment Video
Updated: Jul 25, 2025
06:21
Author Spotlight: Genetic Profiling for Fluorouracil Response in Gastric Cancer
Published on: May 10, 2024
777
FOLFIRI Followed by FOLFOX6 or the Reverse Sequence in Advanced Colorectal Cancer: A Randomized GERCOR Study
Christophe Tournigand1, Thierry André1, Emmanuel Achille1
1From the GERCOR; Hôpital Saint-Antoine; Hôpital Tenon; Hôpital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium.
Summary
This study compared two chemotherapy sequences for metastatic colorectal cancer, finding similar overall survival and efficacy between FOLFIRI followed by FOLFOX6 and FOLFOX6 followed by FOLFIRI. Both regimens demonstrated comparable outcomes but had distinct toxicity profiles.
Area of Science:
- Oncology
- Clinical Pharmacology
- Cancer Treatment
Background:
- Fluorouracil (FU) plus leucovorin (LV) combined with irinotecan or oxaliplatin shows superiority in metastatic colorectal cancer.
- Optimizing chemotherapy sequencing is crucial for improving patient outcomes in metastatic colorectal cancer.
Purpose of the Study:
- To compare the efficacy and safety of two sequential chemotherapy regimens in previously untreated metastatic colorectal cancer patients.
- Investigate the sequence of folinic acid, FU, and irinotecan (FOLFIRI) followed by folinic acid, FU, and oxaliplatin (FOLFOX6) versus the reverse sequence (FOLFOX6 then FOLFIRI).
Main Methods:
- Phase III randomized trial involving previously untreated metastatic colorectal cancer patients.
- Patients received either FOLFIRI followed by FOLFOX6 (Arm A) or FOLFOX6 followed by FOLFIRI (Arm B) upon disease progression.
- Chemotherapy included specific doses and infusions of leucovorin, fluorouracil, irinotecan, and oxaliplatin.
Main Results:
- Median survival was similar between the two arms (21.5 months vs. 20.6 months, P = .99).
- Second progression-free survival (PFS) showed no significant difference (14.2 months vs. 10.9 months, P = .64).
- First-line FOLFIRI and FOLFOX6 demonstrated comparable response rates (56% vs. 54%) and median PFS (8.5 months vs. 8.0 months).
Conclusions:
- Both sequential FOLFIRI and FOLFOX6 regimens achieve prolonged survival and similar efficacy in metastatic colorectal cancer.
- The two treatment sequences exhibit distinct toxicity profiles, with FOLFIRI associated with more mucositis and nausea/vomiting, and FOLFOX6 with more neutropenia and neurosensory toxicity.
- Treatment sequencing does not significantly impact overall survival, but toxicity management should consider the specific regimen.
Related Concept Videos
02:56Treatment Resistant Cancers
3.4K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.4K
01:21Cancer Survival Analysis
402
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
402
02:57Targeted Cancer Therapies
7.7K
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
There are several types of targeted therapies against...
7.7K
01:29Drugs for Treatment of Ulcerative Colitis in IBD
179
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
179
01:05Cancer-Critical Genes II: Tumor Suppressor Genes
7.5K
Genes usually encode proteins necessary for the proper functioning of a healthy cell. Mutations can often cause changes to the gene expression pattern, thereby altering the phenotype.
When the function of certain critical genes, especially those involved in cell cycle regulation and cell growth signaling cascades, gets disrupted, it upsets the cell cycle progression. Such cells with unchecked cell cycles start proliferating uncontrollably and eventually develop into tumors.
Such genes that act...
When the function of certain critical genes, especially those involved in cell cycle regulation and cell growth signaling cascades, gets disrupted, it upsets the cell cycle progression. Such cells with unchecked cell cycles start proliferating uncontrollably and eventually develop into tumors.
Such genes that act...
7.5K