FOLFIRINOX chemotherapy

FOLFIRINOX is a combination of five chemotherapy agents.

What is it?

It is given to patients with metastatic pancreatic cancer (that has spread to other parts of the body). It may also be used if you have locally advanced pancreatic cancer (that is inoperable but not spread). In some cases it may be given before surgery (as a neo-adjuvant) to try and shrink the tumour enough for surgery.

FOLFIRINOX is often the first line of treatment for patients with advanced pancreatic cancer. However, it depends upon the tumour and your general health, the side affects can be greater then other chemotherapies.

How is it given?

The treatment will usually consist of 6 to 12 cycles with each cycle lasting a few weeks. Intravenous infusions are given through a thin, short tube (cannula) put into a vein in your arm each time you have treatment. Alternatively, you may have a central line, a portacath or a PICC line inserted just before your treatment starts. These are tubes that give the drugs directly into a large vein in your chest and will stay in place as long as you need them.

What are the side effects?

The side effects of a combination of drugs are usually a mixture of those of each individual drug. It has been found that more than one in ten people will have one or more of the following side effects:

  • Increased risk of an infection due to a drop in white blood cells
  • Tiredness and breathlessness due to a drop in red blood cells
  • Bruising more easily due to a drop in platelets also you may have bleeding gums, nosebleeds or tiny red spots known as petechial.

It is important you tell your medical team if you have any of the above side effects, especially if you develop a temperature above 38oC.

Other common side effects include

  • Tiredness during treatment and sometimes for months afterwards
  • Feeling or being sick (you will be given anti-sickness tablets to help with this)
  • Diarrhoea
  • Hair loss or hair thinning
  • Sore mouth and ulcers
  • Some liver changes (mild and unlikely to cause symptoms)
  • Gritty or watery eyes, blurred vision
  • Sore, red peeling on palms of hands and soles of the feet (known as palmar-plantar syndrome)
  • A brown skin marking following the line of the vein where chemotherapy was injected
  • Skin rashes which may cause itching
  • Some women may find their periods stop (amenorrhoea) this is often temporary

Occasional Side Effects

  • Numbness or tingling in the fingers and toes—this can start within a few weeks and usually goes away a few months after finishing treatment.
  • Brittle, chipped or ridged nails
  • Sensitivity to sunlight
  • Loss of appetite
  • Heart problems
  • Blood clots
  • Difficulty swallowing or breathing which is triggered by cold air.

 Rare Side effects

  • Tinnitus (ringing in the ears) which usually gets better once you’ve finished your treatment
  • Allergic reactions—tell your medical team if you go red in the face, you have an itchy rash or feel breathless or faint. This happens is only 1 in 200 people (0.5%)

Remember—you will not have all of the side effects listed here. You may only have 1 or 2 or several. Talk to your medical team if you are experiencing any form of side effect while on FOLFIRINOX chemotherapy treatment.

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Information Product № Published 03/10/2019
Last Updated 16/10/2019 Next Review Due 02/09/2022