Example orders for mFOLFOX 6 in colon cancer

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mFOLFOX 6

Original references may be found at mFOLFOX 6 (adjuvant) & mFOLFOX 6 (metastatic)

Example regimen #1

• Fluorouracil (5-FU) 400 mg/m2 IV bolus over 10-15 minutes on day 1 after oxaliplatin and leucovorin
• Fluorouracil (5-FU) 1200 mg/m2/day (total dose 2400 mg/m2) IV continuous infusion over 46 hours on days 1-2, given after 5-FU bolus
• Folinic acid (Leucovorin) 400 mg/m2 IV over 2 hours on day 1, given first, concurrently with oxaliplatin
  • Mixed in 250 mL D5W.
• Oxaliplatin (Eloxatin) 85 mg/m2 IV over 2 hours on day 1, given first, concurrently with leucovorin
  • Mixed in 500 mL D5W, and only infuse through D5W line.

14-day cycles x 12 cycles, to start within 10 weeks of surgery (if adjuvant); in metastatic settings, given until progression of disease or unacceptable toxicity

Supportive medications:

• Ondansetron (Zofran) 8 mg IV 30 minutes prior to oxaliplatin
• Dexamethasone (Decadron) 10 mg IV 30 minutes prior to oxaliplatin
• Lorazepam (Ativan) 0.5-1 mg PO prn nausea/anxiety, given 30 minutes prior to chemotherapy
• Calcium gluconate 1 g & magnesium sulfate 1 g (admixed together) IV, given over 30 minutes, to start prior to oxaliplatin to decrease likelihood of neuropathy
• Calcium gluconate 1 g & magnesium sulfate 1 g (admixed together) IV, given over 30 minutes, to start after oxaliplatin infusion is complete to decrease likelihood of neuropathy

Hydration:

• 500 ml D5W at KVO rate as running IV for chemotherapy infusion. Give up to 500 ml D5W.

Monitoring:

• Hold if ANC <1500 or platelets <75 and notify physician.