The original Folfirinox that was FDA approved in 2011 and used until 2018 was 20% higher in dosing of 5-FU, Irinotecan and Oxaliplatin.

(m)Folfirinox- (the “m” standing for modified) was FDA approved in 2018 and is the current “gold standard”. In clinical trials comparing it to the original formulation, it showed just as good efficacy at the 20% reduction of the components and the tolerability was better.

William Isacoff MD (UCLA) was one of the principal investigators running the clinical trials of Folfirinox and (m)Folfirinox. He is a proponent of metronomic dosing where the patient receives a lower dose but infusions are more frequent. This has improved the tolerability while maintaining efficacy.