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Table 1 First-line treatment protocols for patients with metastatic colorectal cancer (mCRC) who are able to tolerate highly intensified treatment

From: Expert consensus on maintenance treatment for metastatic colorectal cancer in China

Chemotherapy protocol

Route and cycles of administration

FOLFOX (mFOLFOX6)a,b

Oxaliplatin 85 mg/m2, intravenous infusion (IV) for 2 h on Day 1;

leucovorin (LV) 400 mg/m2, IV for 2 h on Day 1;

5-fluorouracil (5-FU) 400 mg/m2, IV on Day 1, and then 1200 mg/m2 continuous IV for 2 days (total dose 2400 mg/m2 for 46–48 h)

Protocol repeated every 2 weeks

CapeOxa

Oxaliplatin 130 mg/m2, IV for >2 h on Day 1;

capecitabine 850–1000 mg/m2, oral administration twice daily on Days 1–14, and then discontinued for 7 days

Protocol repeated every 3 weeks

FOLFIRIa,b

Irinotecan 180 mg/m2, IV > 30–90 min on Day 1;

LV 400 mg/m2, IV for 2 h with irinotecan on Day 1;

5-FU 400 mg/m2, IV on Day 1 and then 1200 mg/m2/d continuous IV for 2 days (total dose 2400 mg/m2 for 46–48 h)

Protocol repeated every 2 weeks

FOLFOXIRIa

Irinotecan 165 mg/m2, oxaliplatin 85 mg/m2 plus LV 400 mg/m2, IV on Day 1;

5-FU 1600 mg/m2 per day, continuous IV for 2 days (total dose 3200 mg/m2 for 48 h)

Protocol repeated every 2 weeks

  1. aThe regimen can be used alone or in combination with bevacizumab (5 mg/kg in 2-week protocol or 7.5 mg/kg in 3-week protocol, IV on Day 1 of each cycle)
  2. bThe regimen can be used alone or in combination with panitumumab (6 mg/kg, IV > 60 min, repeated every 2 weeks) or cetuximab (only for patients with wild-type KRAS/NRAS; initial dose 400 mg/m2, IV > 2 h, and then 250 mg/m2, IV > 60 min once a week or 500 mg/m2 every 2 weeks)