FOLFIRI-bevacizumab is an abbreviation for chemotherapy combination used as an initial treatment of colorectal cancer that has spread. It includes the drugs leucovorin (folinic acid), fluorouracil, irinotecan hydrochloride, and bevacizumab. Learn more about this chemotherapy regimen.
Liver Metastases
Image by Kuyohong/Wikimedia
FOLFIRI-Bevacizumab Chemotherapy
What is FOLFIRI-BEVACIZUMAB Chemotherapy?
This combination contains the chemotherapy drugs leucovorin calcium (folinic acid), fluorouracil, and irinotecan hydrochloride and the targeted therapy drug bevacizumab. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.
Drugs in the FOLFIRI-BEVACIZUMAB combination:
FOL
= Leucovorin Calcium (Folinic Acid)
F
= Fluorouracil
IRI
= Irinotecan Hydrochloride
+ Bevacizumab
Each of the drugs in this combination is approved by the Food and Drug Administration (FDA) to treat cancer or conditions related to cancer.
Use in Cancer
FOLFIRI-BEVACIZUMAB is used to treat:
Colorectal cancer that has metastasized (spread to other parts of the body).
This combination may also be used with other drugs or treatments or to treat other types of cancer.
Source: National Cancer Institute (NCI)
FOL = Folinic Acid
Leucovorin Injection
Also called: Leucovorin Calcium
Leucovorin is a prescription medicine used alone or with other drugs to treat certain types of colorectal cancer and anemia and to lessen the toxic effects of the anticancer drug methotrexate or other substances that block the action of folic acid. Leucovorin is a form of folic acid.
Leucovorin Injection
Also called: Leucovorin Calcium
Leucovorin is a prescription medicine used alone or with other drugs to treat certain types of colorectal cancer and anemia and to lessen the toxic effects of the anticancer drug methotrexate or other substances that block the action of folic acid. Leucovorin is a form of folic acid.
Leucovorin calcium is a type of drug called a folic acid analog, which means it is similar to the vitamin folic acid. It is used in combination with certain chemotherapy drugs to enhance their ability to kill cancer cells (for example, fluorouracil) or to lessen their harmful side effects (for example, methotrexate). It is a type of chemoprotective agent and a type of chemosensitizing agent. Leucovorin is the active ingredient of leucovorin calcium. Also called citrovorum factor and folinic acid.
Leucovorin calcium is approved to be used alone or with other drugs to treat:
Colorectal cancer. It is used with fluorouracil as palliative treatment in patients with advanced disease.
Anemia. It is used to treat megaloblastic anemia that occurs when the body does not get enough of a vitamin called folic acid. It is used by patients who cannot take the vitamin by mouth.
Leucovorin calcium is also used to prevent and treat the toxic effects of high-dose methotrexate when used to treat osteosarcoma and other types of cancer. It is also used to treat overdoses of methotrexate or other folic acid antagonists.
The drug is also being studied in the treatment of other conditions and types of cancer.
Leucovorin Calcium - NCI. National Cancer Institute. Aug 21, 2008 [accessed on Nov 09, 2023]
Leucovorin Injection. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
These FAQs provide a summary of the most important information about Leucovorin Injection. If you would like more information or have any questions, talk to your healthcare provider.
F = Fluorouracil
Fluorouracil Injection
Also called: Adrucil®, 5-Fluorouracil, 5-FU
Fluorouracil (Adrucil) is a prescription medicine used to treat cancer of the colon, rectum, breast, stomach, or pancreas. It is given as an injection into the vein (IV), or as an infusion. Fluorouracil is a type of antimetabolite.
Fluorouracil Injection
Also called: Adrucil®, 5-Fluorouracil, 5-FU
Fluorouracil (Adrucil) is a prescription medicine used to treat cancer of the colon, rectum, breast, stomach, or pancreas. It is given as an injection into the vein (IV), or as an infusion. Fluorouracil is a type of antimetabolite.
Fluorouracil is a type of chemotherapy drug called an antimetabolite. It mimics one of the building blocks of RNA and DNA, which disrupts the ability of the cells to make DNA and proteins. This slows or stops the growth of cancer cells and other rapidly dividing cells and causes them to die.
Fluorouracil injection is approved to treat:
Breast cancer.
Colorectal cancer.
Gastric (stomach) cancer.
Pancreatic cancer.
Fluorouracil is also called 5-FU. Fluorouracil is also being studied in the treatment of other conditions and types of cancer.
Fluorouracil is also available in a topical form.
Fluorouracil Injection - NCI. National Cancer Institute. Apr 13, 2007 [accessed on Nov 09, 2023]
ADRUCIL (fluorouracil) injection, solution [accessed on Aug 15, 2019]
Fluorouracil Injection. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
These FAQs provide a summary of the most important information about Fluorouracil Injection. If you would like more information or have any questions, talk to your healthcare provider.
Additional Materials (6)
Bowen's disease plaque
Bowen's disease typically presents as a gradually enlarging, well-demarcated red colored plaque with an irregular border and surface crusting or scaling. Bowen's disease may occur at any age in adults, but is rare before the age of 30 years; most patients are aged over 60. Any site may be affected, although involvement of palms or soles is uncommon. Bowen's disease occurs predominantly in women (70–85% of cases). About 60–85% of patients have lesions on the lower leg, usually in previously or presently sun-exposed areas of skin.
This is a persistent, progressive, unelevated, red, scaly or crusted plaque which is due to an intraepidermal carcinoma and is potentially malignant. The lesions may occur anywhere on the skin surface, including on mucosal surfaces. Freezing, cauterization, or diathermy coagulation is often effective treatment. Pathomorphologic study of tissue sampling revealed: polymorphism of spiny epithelial cells has progressed into atypism; increased mitosis; giant and multinucleate cells; acanthosis; hyperkeratosis and parakeratosis; basal membrane and basal layer are retained.
Causes Edit
Causes of Bowen's disease include solar damage, arsenic, immunosuppression (including AIDS), viral infection (human papillomavirus or HPV), chronic skin injury, and other dermatoses.[4]
Histology Edit
In Bowen's disease, atypical squamous cells proliferate through the whole thickness of the epidermis. The entire tumor is confined to the epidermis and does not invade into the dermis. The cells in Bowen's disease are often highly atypical under the microscope, and may in fact look more unusual than the cells of some invasive squamous cell carcinomas.
Bowen's disease as seen under a microscope
Bowen disease (2).jpg
Bowen disease (3).jpg
Bowen disease (4).jpg
Treatment Edit
Photodynamic therapy, cryotherapy (freezing), or local chemotherapy (with 5-fluorouracil) are favored by some clinicians over excision. Because the cells of Bowen's disease have not invaded the dermis, it has a much better prognosis than invasive squamous cell carcinoma.
Good results have been noted with the use of imiquimod for Bowen's disease, including on the penis (erythroplasia of Queyrat), although imiquimod is not (as of 2013) approved by the U.S. Food and Drug Administration for the treatment of any type of squamous cell carcinoma, and serious side effects can occur with use of imiquimod.
References Edit
^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
Image by Masryyy/Wikimedia
Severe Toxicity Under 5- Fluorouracil-Based Therapy
Video by Mayo Proceedings/YouTube
Fluorouracil and Pet Safety | How You Can Keep Your Pets Safe When Using 5-FU
Video by U.S. Food and Drug Administration/YouTube
What is FEC and Docetaxel combination chemotherapy and what are its side effects? | OncoPower
Video by OncoPower/YouTube
What is FEC chemotherapy and what are its side effects? | OncoPower
Video by OncoPower/YouTube
What is FEC and Paclitaxel combination chemotherapy and what are its side effects? | OncoPower
Video by OncoPower/YouTube
Bowen's disease plaque
Masryyy/Wikimedia
4:47
Severe Toxicity Under 5- Fluorouracil-Based Therapy
Mayo Proceedings/YouTube
4:43
Fluorouracil and Pet Safety | How You Can Keep Your Pets Safe When Using 5-FU
U.S. Food and Drug Administration/YouTube
5:57
What is FEC and Docetaxel combination chemotherapy and what are its side effects? | OncoPower
OncoPower/YouTube
6:13
What is FEC chemotherapy and what are its side effects? | OncoPower
OncoPower/YouTube
5:59
What is FEC and Paclitaxel combination chemotherapy and what are its side effects? | OncoPower
OncoPower/YouTube
IRI = Irinotecan Hydrochloride
Irinotecan Injection
Also called: Camptosar®, CPT-11, Irinotecan Hydrochloride
Irinotecan hydrochloride (Camptosar) is a prescription medicine used alone or with other drugs to treat certain adults with colorectal cancer that has spread to other parts of the body. It is a type of chemotherapy medicine called a topoisomerase I inhibitor.
Irinotecan Injection
Also called: Camptosar®, CPT-11, Irinotecan Hydrochloride
Irinotecan hydrochloride (Camptosar) is a prescription medicine used alone or with other drugs to treat certain adults with colorectal cancer that has spread to other parts of the body. It is a type of chemotherapy medicine called a topoisomerase I inhibitor.
Irinotecan hydrochloride is a prescription medicine used alone or with other drugs to treat colorectal cancer that has spread to other parts of the body. It is used in patients whose cancer has not already been treated or whose cancer has recurred (come back) or has gotten worse after treatment with anticancer drugs that included fluorouracil. Irinotecan hydrochloride blocks a certain enzyme needed for cell division and DNA repair, and it may kill cancer cells. It is a type of topoisomerase inhibitor and a type of camptothecin analog. Irinotecan is the active ingredient of irinotecan hydrochloride. Also called Camptosar and CPT 11.
Irinotecan hydrochloride is approved to be used alone or with other drugs to treat:
Colorectal cancer that has metastasized (spread to other parts of the body), including metastatic cancer that has recurred (come back) or has not gotten better with other chemotherapy.
Irinotecan hydrochloride is also being studied in the treatment of other types of cancer.
Irinotecan hydrochloride is also available in a different form called irinotecan hydrochloride liposome.
Irinotecan Hydrochloride - NCI. National Cancer Institute. Apr 20, 2007 [accessed on Oct 03, 2023]
Irinotecan Injection. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
These FAQs provide a summary of the most important information about Irinotecan Injection. If you would like more information or have any questions, talk to your healthcare provider.
Bevacizumab
Bevacizumab Injection
Also called: Avastin®
Bevacizumab (Avastin) is a prescription medicine used to treat a number of types of cancers, such as colorectal, ovarian, cervical, kidney, lung and brain cancers. It may also be used off-label to treat macular degeneration.
Bevacizumab Injection
Also called: Avastin®
Bevacizumab (Avastin) is a prescription medicine used to treat a number of types of cancers, such as colorectal, ovarian, cervical, kidney, lung and brain cancers. It may also be used off-label to treat macular degeneration.
Bevacizumab is a type of targeted therapy called an angiogenesis inhibitor. It is a monoclonal antibody that works by blocking the growth of blood vessels that are needed to support tumor growth.
Bevacizumab is approved to be used alone or with other drugs to treat:
Cervical cancer that has not gotten better with other treatment, has spread to other parts of the body, or has come back. It is used with paclitaxel and either cisplatin or topotecan hydrochloride. This use is approved for the Alymsys, Avastin, Mvasi, and Zirabev brands of bevacizumab.
Colorectal cancer that has spread to other parts of the body. It is used:
With fluorouracil as the first or second treatment.
With a fluoropyrimidine and either irinotecan hydrochloride or oxaliplatin as the second treatment in patients whose disease has gotten worse after therapy that included bevacizumab.
This use is approved for the Alymsys, Avastin, Mvasi, and Zirabev brands of bevacizumab.
Glioblastoma (a type of brain cancer) that has come back. It is used in adults. This use is approved for the Alymsys, Avastin, Mvasi, and Zirabev brands of bevacizumab.
Hepatocellular carcinoma (a type of liver cancer) that has spread to other parts of the body or cannot be removed by surgery. It is used with atezolizumab in patients who have not received systemic therapy. This use is approved for the Avastin brand of bevacizumab.
Nonsquamous non-small cell lung cancer that is has spread, cannot be removed by surgery, or has come back. It is used with carboplatin and paclitaxel as the first therapy. This use is approved for the Alymsys, Avastin, Mvasi, and Zirabev brands of bevacizumab.
Ovarian epithelial,fallopian tube, or primary peritoneal cancer. It is used:
With carboplatin and paclitaxel and then alone in patients with stage III, stage IV, or recurrent cancer. It is given after surgery. This use is approved for the Avastin, Mvasi, and Zirabev brands of bevacizumab.
With paclitaxel, doxorubicin hydrochloride liposome, or topotecan hydrochloride in patients whose cancer has come back, does not respond to platinum chemotherapy, and has been treated with up to two types of chemotherapy. This use is approved for the Alymsys, Avastin, Mvasi, and Zirabev brands of bevacizumab.
With carboplatin and paclitaxel or carboplatin and gemcitabine hydrochloride and then alone in patients whose cancer responds to platinum chemotherapy and has come back. This use is approved for the Avastin, Mvasi, and Zirabev brands of bevacizumab.
Renal cell carcinoma (a type of kidney cancer) that has spread to other parts of the body. It is used with interferon alpha. This use is approved for the Alymsys, Avastin, Mvasi, and Zirabev brands of bevacizumab.
Bevacizumab is also being studied in the treatment of other types of cancer.
Before you receive bevacizumab, tell your healthcare provider if you:
Undergoing surgery. Bevacizumab should not be used for 28 days before or after surgery and until surgical wounds are fully healed
Pregnant or think you are pregnant. Data have shown that bevacizumab may harm your unborn baby. Use birth control while on bevacizumab. If you stop bevacizumab, you should keep using birth control for 6 months before trying to become pregnant
Planning to become pregnant. Taking bevacizumab could cause a woman’s ovaries to stop working and may impair her ability to have children
Breastfeeding. Breastfeeding while on bevacizumab may harm your baby, therefore, women should not breastfeed during and for 6 months after taking bevacizumab
Know the medicines you take. Keep a list of them and show your healthcare provider and pharmacist when you get a new medicine.
The most common side effects of bevacizumab are nose bleed and high blood pressure; however, serious and potentially fatal side effects of Avastin include:
Massive bleeding requiring blood transfusions
Development of perforations (or holes) in the body including the nose (nasal septal perforation) and the stomach and intestines (gastrointestinal perforation and fistulas)
Severe high blood pressure
Blood clots (arterial and venous thrombosis)
Heart attack (myocardial infarction), heart failure and stroke
Kidney damage
Wounds that do not heal or scars from surgery that open up (dehiscence)
Development of reversible posterior leukoencephalopathy syndrome (RPLS), a syndrome characterized by high blood pressure, headaches, confusion, seizures, visual loss, and evidence of swelling of the brain on brain (MRI) scans.
Tell your healthcare provider about any side effect that bothers you or that does not go away.
These are not all the possible side effects of bevacizumab. For more information, ask your healthcare provider or pharmacist.
Questions and Answers about Avastin | FDA. U.S. Food and Drug Administration. Oct 29, 2015 [accessed on Jul 26, 2023]
Bevacizumab - NCI. National Cancer Institute. Oct 5, 2006 [accessed on Jul 26, 2023]
Avastin® (bevacizumab) Safety, Side Effects & Patient Financial Support. avastin [accessed on Jul 26, 2023]
AVASTIN (bevacizumab) injection, solution [accessed on Aug 18, 2019]
Bevacizumab Injection. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
These FAQs provide a summary of the most important information about Bevacizumab Injection. If you would like more information or have any questions, talk to your healthcare provider.
Additional Materials (5)
Cancer: Bevacizumab (Avastin)
Video by Bowel Cancer Australia/YouTube
Wet macular degeneration treatment
Wet macular degeneration treatment
Image by Sanjay Sharma
Capillaries and Dense Micro-Vascularization
Capillaries and Dense Micro-Vascularization
Image by TheVisualMD
Schematic representation of the different isoforms of human vascular endothelial growth factor.
Schematic representation of the different isoforms of human vascular endothelial growth factor.
Image by Eduardoalexandre
Vascular endothelial growth factor
Structure of the VEGFA protein. Based on PyMOL rendering of PDB 1bj1
Image by Emw
5:38
Cancer: Bevacizumab (Avastin)
Bowel Cancer Australia/YouTube
Wet macular degeneration treatment
Sanjay Sharma
Capillaries and Dense Micro-Vascularization
TheVisualMD
Schematic representation of the different isoforms of human vascular endothelial growth factor.
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FOLFIRI-Bevacizumab Chemotherapy for Colorectal Cancer
FOLFIRI-bevacizumab is an abbreviation for chemotherapy combination used as an initial treatment of colorectal cancer that has spread. It includes the drugs leucovorin (folinic acid), fluorouracil, irinotecan hydrochloride, and bevacizumab. Learn more about this chemotherapy regimen.