Cancers & treatments·Regimen libraryFirst line

FOLFIRI

Checked 2026-09-09

Metastatic colorectal first or second line (with bevacizumab, aflibercept, ramucirumab or an anti-EGFR antibody)

Also called FOLFIRI-BEVACIZUMAB, FOLFIRI-CETUXIMAB.

One cycle

every 14 days

14-day cycle, until progressionIntravenous Continuous infusion

Components

Drug	Dose	Route	Days	Note
Irinotecan Topoisomerase I inhibitor (camptothecin prodrug)	180 mg/m²	IV	D1
Leucovorin (folinic acid)	400 mg/m²	IV	D1	2-hour infusion before fluorouracil
Fluorouracil bolus Fluoropyrimidine antimetabolite	400 mg/m²	IV	D1
Fluorouracil infusion Fluoropyrimidine antimetabolite	2,400 mg/m²	IV	D1, 2 (46 h infusion)

Cycles

until progression

14-day cycle

Emetogenicity

Moderate (30-90%)

G-CSF

Not routine

Notes

UGT1A1*28 homozygotes have higher neutropenia risk; consider a lower irinotecan start dose.

Used in

Colorectal cancer Gastric & gastro-oesophageal junction cancer

Trials

CRYSTAL & FIRE-3

Products

FOLFIRI (5-FU, leucovorin, irinotecan)Irinotecan (and liposomal irinotecan)Fluorouracil (5-FU)

Source

NCCN Colon Cancer; Douillard, Lancet 2000

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.