Toxicity Profile of Each Drug in FOLFIRINOX

Oxaliplatin

– Peripheral Neuropathy: Occurs in approximately 6.9% of patients. This can be persistent and may last beyond the treatment period.

– Neutropenia: Around 15.3% of patients experience grade 3 or 4 neutropenia.

– Thrombocytopenia: Occurs in about 6.8% of patients.

 Irinotecan

– Diarrhea: Grade 3 or 4 diarrhea occurs in about 17.1% to 20% of patients, with a higher likelihood during the first two cycles.

– Neutropenia: Approximately 15.9% of patients experience grade 3 or 4 neutropenia.

– Febrile Neutropenia: Occurs in about 3.4% to 6.8% of patients.

Leucovorin (Folinic Acid)

Leucovorin is generally well-tolerated and mainly serves to enhance the efficacy of 5-fluorouracil. It does not have significant standalone toxicities but can contribute to the overall toxicity profile of the regimen.

 5-Fluorouracil (5-FU)

– Mucositis: Occurs in about 3.6% of patients.

– Nausea and Vomiting: Around 3.4% of patients experience these side effects.

– Fatigue: Reported in about 6.8% of patients.

– Neutropenia: Similar to the other drugs, 5-FU also contributes to neutropenia, with an incidence of about 15.3%.

– Hand-Foot Syndrome: Although not frequently listed in the provided sources, it is a known side effect of 5-FU in other contexts.

 Overall Toxicity Profile

Hematologic Toxicities:

– Neutropenia: 18.1%.

– Anemia: 5.1% to 6.8%.

– Leukopenia: 1.7% to 9.1%.

– Thrombocytopenia: 6.8% to 11.4%.

Non-Hematologic Toxicities:

– Nausea: 3.4%.

– Vomiting: 3.4%.

– Diarrhea: 1.7% to 4.5%.

– Mucositis: 3.6%.

– Fatigue: 6.8%.

– Peripheral Neuropathy: 6.9%.

Severe Toxicities and Treatment Modifications:

– Severe Toxicity (Grade 3 or 4): Occurs in about 35.6% of patients.

– Treatment-Related Mortality: 0.0% to 4.5%.

– Dose Reductions: Needed in about 40.0% of patients.

– Treatment Delays: Occur in about 45.8% to 47.7% of patients