Onco Wiki / Regimen

mFOLFIRINOX (modified FOLFIRINOX, PRODIGE-24 protocol)

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Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

ComponentsDRUG-OXALIPLATIN DRUG-LEUCOVORIN DRUG-IRINOTECAN DRUG-5-FLUOROURACIL
IDREG-MFOLFIRINOX
TypeRegimen
Statusreviewed 2026-05-08 | pending_clinical_signoff
DiseasesNone declared
SourcesSRC-ESMO-PANCREATIC-2024 SRC-NCCN-PANCREATIC-2025 SRC-PRODIGE-24-CONROY-2018

Notes

PRODIGE-24/CCTG PA.6 (Conroy 2018, NEJM): modified FOLFIRINOX (oxaliplatin 85, leucovorin 400, irinotecan 150 — REDUCED from 180 of ACCORD-11 — and 5-FU 2400 mg/m² CIV over 46h with NO bolus) × 12 cycles vs gemcitabine monotherapy adjuvant after R0/R1 resected PDAC (n=493). Median DFS 21.6 vs 12.8 mo (HR 0.58, p<0.001); median OS 54.4 vs 35.0 mo (HR 0.64). Grade 3-4 toxicity 75.9% (mFOLFIRINOX) vs 52.9% (gem) — higher but tolerable in fit ECOG 0-1 patients. Established mFOLFIRINOX as the preferred adjuvant standard, superseding gemcitabine monotherapy. Two key modifications vs full FOLFIRINOX (REG-FOLFIRINOX): irinotecan 150 mg/m² (not 180) and 5-FU bolus OMITTED. These reduce mucositis and cumulative febrile-neutropenia risk over the 12-cycle adjuvant course.

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