{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:47:42Z","timestamp":1787496462441,"version":"build-2736575974"},"update-to":[{"DOI":"10.1200\/jco.2004.05.113","type":"new_edition","label":"New edition","source":"publisher","updated":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000}}],"reference-count":0,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"19","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"\n PURPOSE<\/jats:title>\n In metastatic colorectal cancer, phase III studies have demonstrated the superiority of fluorouracil (FU) with leucovorin (LV) in combination with irinotecan or oxaliplatin over FU + LV alone. This phase III study investigated two sequences: folinic acid, FU, and irinotecan (FOLFIRI) followed by folinic acid, FU, and oxaliplatin (FOLFOX6; arm A), and FOLFOX6 followed by FOLFIRI (arm B).<\/jats:p>\n <\/jats:sec>\n \n PATIENTS AND METHODS<\/jats:title>\n \n Previously untreated patients with assessable disease were randomly assigned to receive a 2-hour infusion of l-LV 200 mg\/m\n 2<\/jats:sup>\n or dl-LV 400 mg\/m\n 2<\/jats:sup>\n followed by a FU bolus 400 mg\/m\n 2<\/jats:sup>\n and 46-hour infusion 2,400 to 3,000 mg\/m\n 2<\/jats:sup>\n every 46 hours every 2 weeks, either with irinotecan 180 mg\/m\n 2<\/jats:sup>\n or with oxaliplatin 100 mg\/m\n 2<\/jats:sup>\n as a 2-hour infusion on day 1. At progression, irinotecan was replaced by oxaliplatin (arm A), or oxaliplatin by irinotecan (arm B).\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Median survival was 21.5 months in 109 patients allocated to FOLFIRI then FOLFOX6 versus 20.6 months in 111 patients allocated to FOLFOX6 then FOLFIRI ( P = .99). Median second progression-free survival (PFS) was 14.2 months in arm A versus 10.9 in arm B ( P = .64). In first-line therapy, FOLFIRI achieved 56% response rate (RR) and 8.5 months median PFS, versus FOLFOX6 which achieved 54% RR and 8.0 months median PFS ( P = .26). Second-line FOLFIRI achieved 4% RR and 2.5 months median PFS, versus FOLFOX6 which achieved 15% RR and 4.2 months PFS. In first-line therapy, National Cancer Institute Common Toxicity Criteria grade 3\/4 mucositis, nausea\/vomiting, and grade 2 alopecia were more frequent with FOLFIRI, and grade 3\/4 neutropenia and neurosensory toxicity were more frequent with FOLFOX6.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Both sequences achieved a prolonged survival and similar efficacy. The toxicity profiles were different.<\/jats:p>\n <\/jats:sec>","DOI":"10.1200\/jco.22.02774","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T18:00:21Z","timestamp":1687975221000},"page":"3469-3477","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":16,"title":["FOLFIRI Followed by FOLFOX6 or the Reverse Sequence in Advanced Colorectal Cancer: A Randomized GERCOR Study"],"prefix":"10.1200","volume":"41","author":[{"given":"Christophe","family":"Tournigand","sequence":"first","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Achille","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Lledo","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Flesh","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Mery-Mignard","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Quinaux","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Couteau","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Buyse","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Ganem","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Landi","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Colin","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Louvet","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimery","family":"de Gramont","sequence":"additional","affiliation":[{"name":"From the GERCOR; H\u00f4pital Saint-Antoine; H\u00f4pital Tenon; H\u00f4pital Georges Pompidou; Aventis; International Drug Development Institute, Paris; Clinique de l'Orangerie, Strasbourg; Clinique Saint-Jean, Lyon; Clinique Drevon, Dijon; Centre Jean Bernard, Le Mans; Clinique Courlancy, Reims, France; International Drug Development Institute, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.22.02774","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T18:00:38Z","timestamp":1687975238000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.22.02774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":0,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2023,7,1]]}},"alternative-id":["10.1200\/JCO.22.02774"],"URL":"https:\/\/doi.org\/10.1200\/jco.22.02774","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,1]]},"assertion":[{"value":"2023-06-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}