Folfirinox
the New Kid on the Block

Folfirinox is the latest drug combination to show promise in the fight against advanced pancreatic cancer. Although mom hasn't personally used this chemotherapy treatment yet, her oncologist is keeping it in the mix as a back-up to her current regimen of Gemzar.

Because Folfirinox has shown such promise I felt that it was important to include it here. I'd like to share what we've learned about this treatment. It packs a surprising punch, and is a Big Step in the right direction as far as pancreatic cancer survival rates are concerned.

Folfirinox (pronounced full-fear-o-knocks)is made up of the following drugs:

• FOL – folinic acid (leucovorin), a vitamin B derivative that helps reduce the side effects of fluorouracil;

• F – fluorouracil (5-FU), gets into the DNA cancer molecule and stops synthesis;

• IRI – irinotecan (Camptosar), prevents DNA cancer cell from uncoiling and duplicating, and;

• NOX –Oxaliplatin, inhibits DNA synthesis in cancer cells.

This new chemotherapy treatment was studied in France and the findings were released in June 2010 at the American Society of Clinical Oncology(ASCO)Annual Meeting.

The clinical study found that Folfirinox appeared to be more effective than the standard drug Gemzar as a treatment for people with metastatic pancreatic cancer. The patients who received Folfirinox lived longer than those who received Gemzar (11.1 months versus 6.8 months). Also, it took longer for the cancer to continue growing in those who received it than in those who received Gemzar (6.4 months versus 3.3 months).

All this sounds good, right?

So you know there's a downside. And it's a big one. Those nasty side-effects.

Yep, Chemo and Crap just go hand in hand. That's our motto. What the toxic chemo does to the cancer cells it also does to some of your healthy cells. It's just not fair. But then, who said life is fair? We fight to live another day, a week, a month, sometimes we pay the price.

Since this chemo regimen is actually 3 chemo drugs in one (plus the vitamin B booster), you can expect the full array of side effects:

* Nausea 

* Fatigue 

* Mouth Sores 

* Low Blood Counts

* Mild to Severe Pain

* Hair Loss

* Diarrhea

* Fever/flu-Like symptoms

* Sensory Neuropathy

Sensory neuropathy is a problem for some people who have chemotherapy with oxaliplatin. Nerves that are damaged by anticancer medicines may cause pain, tingling, numbness, or other uncomfortable sensations. It usually begins in the feet and hands and may get worse with time, spreading to other parts of the body. If it gets too bad, people are taken off oxaliplatin. Sometimes the neuropathy goes away after stopping the medicine. But for other people, the nerve damage may be permanent.

As you can see, the list is lengthy. However, as before, most patients do NOT experience all of these side-effects. The most common one seems to be the sensory neuropathy.

And that brings me to the use of Folfiri. As oxaliplatin is the culprit that causes the neuropathy, if that side-effect becomes too troublesome, many doctors choose to remove it from the mix. Thus folfirinox becomes folfiri.

Folfiri has long been used as a chemotherapy treatment for colorectal cancer. It also appears to be effective in the treatment of advanced pancreatic cancer.

Both of these chemo regimens are offering a hope of more time to pancreatic cancer patients. The side-effects can be severe, but those interviewed in the French study appeared to report that the symptoms were manageable and that their quality of life was higher than when compared to the Gemzar treatment.

Choosing to use the Folfirinox or Folfiri treatment depends on many factors, however, research seems to suggest that this treatment course is usually offered only to patients whose cancer has spread outside of the pancreas. And therein, lies the answer to why mom's doctor is holding it as a back-up. Waiting for the time that her cancer spreads. Cheery thought.

At least, we are thankful to have another weapon in the fight to fall back on. And that gives Hope for another day... 

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