modified FOLFOX-6 - Oxaliplatin 85 / Folinic Acid 400 / Fluorouracil 2400, colon carcinoma adjuvant
Protocol-ID: 644 V1.1 (Short), mFOLFOX-6 (OXAL85/CFOL400/FU2400), Colon Ca, adj.Indication(s)
- Colon Cancer; ICD-10 C18.0, C18.2, C18.3, C18.4, C18.5, C18.6, C18.7, C18.8, C19
Protocol classification
- Classification: current standard
- Intensity: Standard dose
- Therapy phase:
- Therapy intention: curative
Cycles
Cycle length 14 days, recommended cycles: 12
Risks
- Emetogenicity (MASCC/ESMO): moderate (30-90%)
- Neutropenia: high (21-40%)
- Febrile Neutropenia: low (<10%)
- Thrombocytopenia below 50 000/µl: low (<10%) °3-4: 3.4%
- Diarrhea: CTC AE °3-4: 9.7%
- Fatigue: CTC AE °3-4: 7.2%
- Thromboembolic Event: CTC AE °3-4: 4.6%
- Neuropathy: CTC AE °3-4: 14.4%, sensory
- Dehydration: CTC AE °3-4: 4.0%
- Allergic Reaction: CTC AE °3-4: 4.7%
- Pain: CTC AE °3-4: 6.3%
Therapy
HYD Hydration: Balanced Crystalloid Solution | |||||||
| Access: peripheral venous | |||||||
| Hydration before, during, or after antitumor therapy | |||||||
| Day | Substance | Dosage | Solution | Appl. | Inf. time | Procedure | |
|---|---|---|---|---|---|---|---|
| 1 | Balanced Crystalloid Solution | 500 ml | i.v. | 60 min | 60 min before Oxaliplatin (d1) | ||
AE Antiemesis: Emetogenicity moderate, GRAN i.v., DEXA i.v. | |||||||
| Access: peripheral venous | |||||||
| ASCO 2015, DGHO 2016, DKG 2016, MASCC/ESMO 2016, if palonosetron not available | |||||||
| Day | Substance | Dosage | Solution | Appl. | Inf. time | Procedure | |
|---|---|---|---|---|---|---|---|
| 1 | Dexamethasone | 8 mg | NaCl 0.9% 50 ml | i.v. | 5 min | 30 min before Oxaliplatin (d1) | |
| 1 | Granisetron | 1 mg | NaCl 0.9% 50 ml | i.v. | 5 min | 15 min before Oxaliplatin (d1) | |
| or other 5-HT3 receptor antagonist | |||||||
| 2-3 | Dexamethasone | 8 mg | p.o. | 1-0-0-0 | |||
CTX Antineoplastic therapy: mFOLFOX6 | |||||||
| Access: central venous, port | |||||||
| Day | Substance | Dosage | Solution | Appl. | Inf. time | Procedure | |
|---|---|---|---|---|---|---|---|
| 1 | Oxaliplatin | 85 mg/m² BSA | Dextrose 5% 500 ml | i.v. | 2 h | Sequence | |
| 1 | Folinic acid | 400 mg/m² BSA | NaCl 0.9% 250 ml | i.v. | 2 h | Sequence | |
| 1 | Fluorouracil | 400 mg/m² BSA | none | i.v. | 1 min | Sequence | |
| Bolus application | |||||||
| 1 | Fluorouracil | 2400 mg/m² BSA | NaCl 0.9% 500 ml | i.v. | 46 h | Sequence | |
| The volume of the carrier solution refers to inpatient therapy with infusion pumps. When using syringe pumps or ambulatory systems, a different volume (e.g. 100 ml) can be used. | |||||||
References
- Allegra CJ, Initial safety report of NSABP C-08: A randomized phase III study of modified FOLFOX6 with or without bevacizumab for the adjuvant treatment of patients with stage II or III colon cancer. J Clin Oncol 2009 Jul 10;27(20):3385-90. doi: 10.1200/JCO.2009.21.9220. PMID: 19414665. [PMID]
- Allegra CJ, Phase III trial assessing bevacizumab in stages II and III carcinoma of the colon: results of NSABP protocol C-08. J Clin Oncol 2011 Jan 01;29(1):11-6. doi: 10.1200/JCO.2010.30.0855. PMID: 20940184. [PMID]
Recommendations
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Valid since: 04.01.2024