Research Papers:

Folinic acid in colorectal cancer: esquire or fellow knight? Real-world results from a mono institutional, retrospective study

Francesco Jacopo Romano _, Carmela Barbato, Maria Biglietto, Vincenzo Di Lauro, Dario Arundine, Roberto Fiorentino, Francesca Ambrosio, Maresa Cammarota, Bruno Chiurazzi, Livio Puglia, Sarah Scagliarini, Raffaella Ruocco, Carmen Mocerino, Ivana Cerillo, Maria Fiorella Brangi and Ferdinando Riccardi

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Oncotarget. 2021; 12:221-229. https://doi.org/10.18632/oncotarget.27872

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Francesco Jacopo Romano1, Carmela Barbato1, Maria Biglietto1, Vincenzo Di Lauro2, Dario Arundine2, Roberto Fiorentino1, Francesca Ambrosio1, Maresa Cammarota3, Bruno Chiurazzi1, Livio Puglia1, Sarah Scagliarini1, Raffaella Ruocco1, Carmen Mocerino1, Ivana Cerillo1, Maria Fiorella Brangi1 and Ferdinando Riccardi1

1 Antonio Cardarelli Hospital, Oncology Unit, Naples, Italy

2 Federico II University, Department of Medicine and Surgery, Oncology Unit, Naples, Italy

3 Antonio Cardarelli Hospital, Pharmacy Unit, Naples, Italy

Correspondence to:

Francesco Jacopo Romano,email: [email protected]

Keywords: colorectal cancer; folinic acid; sodium levofolinate; thymidylate synthase; non oncogene addiction

Received: September 28, 2020     Accepted: January 07, 2021     Published: February 02, 2021

Copyright: © 2021 Romano et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


The stock of therapeutic weapons available in metastatic colorectal cancer (mCRC) has been progressively grown over the years, with improving both survival and patients' clinical outcome: notwithstanding advances in the knowledge of mCRC biology, as well as advances in treatment, fluoropyrimidine antimetabolite drugs have been for 30 years the mainstay of chemotherapy protocols for this malignancy. 5-Fluorouracil (5FU) seems to act differently depending on administration method: elastomer-mediated continuous infusion better inhibits Thymidylate Synthase (TS), an enzyme playing a pivotal role in DNA synthetic pathway. TS overexpression is an acknowledged poor prognosis predicting factor. The simultaneous combination of 5FU and folinate salt synergistically strengthens fluorouracil cytotoxic effect. In our experience, levofolinate and 5FU together in continuous infusion prolong progression free survival of patients suffering from mCRC, moreover decreasing death risk and showing a clear clinical benefit for patients, irrespective of RAS mutational status, primitive tumor side and metastases surgery.

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