FOLFIRI chemotherapy is a combination of Folinic acid, 5-Flurouracil and Irinecan Hydrochloride used as second or third line therapy when relapsed or metastatic stomach cancer is present.
This is normally administered via a central line (Hickmann) and a typical drug regimen is given as a cycle every 2 weeks over a few months, the actual number of cycles depends on response and your tolerance and side effects to the treatment.
FOLFIRI or a modified version is an abbreviation from the drugs given:
FOLinic Acid (Trade Name: Leucovorin)
Flurouracil (5-FU) (Trade Name:Adrucil, Efudex)
IRInecan Hydrochloride (Trade Name: Campto, Camptostar)
It is a two combination therapy as the Folinic acid is in the regimen to potentiate the effects of the 5-Flurouracil.
Irinecan hydrochloride is a topisimerase 1 inhibitor, a camptothecan analog derived from Camptotheca acuminata or ‘Happy Tree’.
Topisimerase 1 is an enzyme that handles the modelling of DNA, required to for cells to actively divide.
By blocking the enzyme, Irinecan prevents cancer cells from dividing and growing.
The Folinic acid and Irinecan is given as a drip or infusion over 90 minutes to 2 hours and the 5-FU is given as a bolus injection through your line.
Like all forms of chemotherapy, side effects do occur including:
Hyperhidrosis or excessive sweating
Allergy to the medicines
Hypersalivation or increased saliva
Neutropenia – Low white blood cell count with risk of severe infection usually around day ten to fourteen although it can occur at any time.
General Fatigue and excessive tiredness
Hair loss or ‘alopecia’
Thrombocytopenia (low platelets) and bruising – platelets are clotting cells that are required by your body to stop bleeding.
Anemia – a common cause of tiredness, but has other effects such as breathlessness and headaches.
Nausea, Vomiting and Diarrhea
Neuropathy – causes numbness or “pins and needles” in your hands and feet
Mucositis – Sore mouth due to ulceration and inflammation making eating difficult.
Photosensitivity – your skin can become sensitive to light causing sunburn.
FOLFIRI can cause fertility issues. If you are young is is important to discuss this with your oncologist before having FOLFIRI as you may need to consider egg harvesting before starting this therapy.
Men should also consider sperm storage as infertility can also be an issue.
You must never have any ‘live’ vaccinations as these can become active with this chemo.
Always inform any medical professional that you are on this form of therapy.
You should also avoid anyone with an infection. If you develop a fever or any other new symptoms it is important to seek immediate medical attention.
Good dental or oral hygiene is important. Try to brush your teeth regularly and use mouth wash.
FOLFIRI chemotherapy has a lower response rate compared with FOLFOX therapy with a response rate of between ten and twenty nine percent.
The median overall survival of responders is 10.5 months and is generally quite well tolerated.