We understand that being diagnosed with pancreatic cancer can be a time of stress and worry and hearing lots of new words and phrases can be daunting, especially when it comes to the treatment of the disease. This blog aims to give you an overview of FOLFIRINOX, a type of chemotherapy used to treat pancreatic cancer.
What is FOLFIRINOX?
FOLFIRINOX is a combination of five chemotherapy agents and is used in the UK for patients with metastatic (spread to other parts of the body) pancreatic cancer, locally advanced (inoperable but not spread elsewhere) pancreatic cancer. It is also occasionally used as a neo-adjuvant (before surgery) agent to try to shrink a tumour for surgical removal to be possible.
Can all pancreatic cancer patients be treated with FOLFIRINOX?
FOLFIRINOX is not approved by either NICE (National Institute of Clinical Excellence) in England and Wales nor the SMC (Scottish Medicines Consortium) for pancreatic cancer so is not available as standard treatment for pancreatic cancer.
To find out if you are eligible for any current clinical trials in the UK, speak to your oncologist or click here to see a list of pancreatic cancer clinical trials.
What is the typical treatment regime for FOLFIRINOX?
The treatment will usually consist of the following:
|Day 1||Oxaliplatin (a colourless fluid) infusion (by drip) over 2 hours, followed by Irinotecan (a clear, slightly yellow fluid) and folinic acid (a clear, pale yellow fluid) infusion over 2 hours, followed by Fluorouracil (a colourless fluid) as a fast infusion over 15 minutes, followed by Fluorouracil as a slow infusion over 46 hours (at home) via a pump through a central venous catheter (PICC line).|
|Day 3||District nurse home visit to take pump off and flush line.|
|Repeat of day 1 and start of next cycle of treatment
This treatment is repeated every 2 weeks for a total of 6 to 12 cycles.
Are there any side effects of FOLFIRINOX?
The side effects of a combination of drugs are usually a mixture of those of each individual drug. As Folfirinox is a combination of five chemotherapy agents, the list of possible side-effects is quite extensive and can be found here. Below are just a selection of the possible side-effects that can occur during Folfirinox treatment.
|Increased risk of an infection due to a drop in white blood cells.|
|Bruising more easily due to a drop in platelets also you may have bleeding gums, nosebleeds or tiny red spots known as petechiae.|
|Tiredness during treatment and sometimes up to 6 months afterwards.|
|Feeling or being sick (you will be given anti-sickness tablets to help with this).|
|Diarrhoea—this can be severe in about 11% of patients (11 in 100).|
|Hair loss—affects about 10% (1 in 10) patients.|
FOLFIRINOX is just one of the potential treatments for pancreatic cancer. Treatments for pancreatic cancer vary and are dependent on the stage of the disease and fitness level of the patient. For more information on other treatments for pancreatic cancer, click here.
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.
Please note that the FOLFIRINOX regime can be very toxic and side effects can be greater than the standard therapy – so it is not suitable for all patients. Click here to see the extensive list of side effects associated with FOLFIRINOX.