FOLFIRINOX

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Metastatic Pancreatic Cancer

Regimen

Oxaliplatin*	85 mg/m2 IV	Dilute in 250 to 500 mL 5 percent dextrose in water (D5W)Δ and administer over two hours (prior to leucovorin).	Day 1
Leucovorin◊	400 mg/m2 IV	Dilute in 250 mL D5W and administer over two hours (after oxaliplatin).	Day 1
Irinotecan§	180 mg/m2 IV	Dilute in 500 mL D5W and administer over 90 minutes. Administer concurrent with the last 90 minutes of leucovorin infusion, in separate bags, using a Y-line connection. Day 1
Fluorouracil (FU) 400 mg/m2 IV bolus	Give undiluted (50 mg/mL) as a slow IV push over five minutes (administer immediately after leucovorin). Day 1
Fluorouracil (FU) 2400 mg/m2 IV	Dilute in 500 to 1000 mL 0.9 percent normal saline (NS) or D5W and administer as a continuous IV infusion over 46 hours (begin immediately after FU IV bolus). To accommodate an ambulatory pump for outpatient treatment, can be administered undiluted (50 mg/mL) or the total dose diluted in 100 to 150 mL NS.	Day 1
  • Many centers routinely infuse oxaliplatin via central venous line because of local pain with infusion into a peripheral vein.

Reference

Conroy T, et al. N Engl J Med 2011; 364:1817.