FOLFIRI (5-FU, Leucovorin, and Irinotecan)

FOLFIRI is a combination chemotherapy regimen built from three drugs: 5-fluorouracil (5-FU), leucovorin (folinic acid), and irinotecan. It is most commonly used for advanced colorectal cancer but is sometimes given for other gastrointestinal cancers. The drugs are infused on a schedule, usually every two weeks, often through a port placed under the skin.

Origin

The name is an acronym assembled from FOLinic acid, Fluorouracil, and IRInotecan. The regimen was developed and standardized in the late 1990s, with French oncologist Aimery de Gramont and colleagues publishing key trials that established its role in metastatic colorectal cancer.

Significance in Asbestos Context

FOLFIRI is not a frontline treatment for mesothelioma or lung cancer, the cancers most often linked to asbestos. It becomes relevant when a person with an asbestos exposure history is diagnosed with colorectal or another gastrointestinal cancer, since asbestos has been associated by some studies (and accepted under the Helsinki Criteria in certain contexts) with elevated risk of laryngeal, ovarian, and possibly colorectal cancers. If a treating oncologist prescribes FOLFIRI, the diagnosis, pathology report, and treatment records become important documents both for medical care and for any claim that links the cancer to occupational asbestos exposure.

Example Sentence

After his colon cancer was diagnosed during workup for unexplained weight loss, the patient began FOLFIRI infusions every two weeks through a chest port.

Related Terms

Chemotherapy, Colorectal Cancer, FOLFOX, 5-Fluorouracil, Irinotecan, Helsinki Criteria

Notes

• Ask the oncologist whether a port (implanted venous access) will be placed before starting, since FOLFIRI is given as a continuous infusion over about 46 hours using a portable pump.
• Common side effects to discuss in advance include diarrhea (sometimes severe with irinotecan), nausea, mouth sores, low blood counts, and hair thinning; ask about loperamide and anti-nausea prescriptions to have on hand.
• Patients of certain genetic backgrounds carry UGT1A1 variants that increase irinotecan toxicity. Ask whether UGT1A1 testing is appropriate before the first cycle.
• Keep copies of the pathology report, staging scans, and chemotherapy records; if you are pursuing an asbestos-related claim involving a gastrointestinal cancer, your legal team will need these to document diagnosis, treatment, and prognosis.
• FOLFIRI is often combined with a targeted biologic such as bevacizumab or cetuximab. Ask whether tumor molecular testing (KRAS, NRAS, BRAF, MSI) has been done, since results affect which drugs can be added.