Rectal Cancer

Question 1

CHEMOTHERAPY FOR ADVANCED OR METASTATIC DISEASE - CHEMOTHERAPY REGIMENS

Answer 1

FOLFOX
FOLFOX + bevacizumab
FOLFOX + panitumumab(KRAS/NRAS WT only) 
FOLFOX + cetuximab (KRAS/NRAS WT only) 
CAPEOX
CAPEOX+bevacizumab
FOLFIRI
FOLFIRI+bevacizumab
FOLFIRI+cetuximab(KRAS/NRAS WT only)
FOLFIRI + panitumumab (KRAS/NRAS WT only)
FOLFIRI + ziv-aflibercept
FOLFIRI + ramucirumab
FOLFOXIRI
FOLFOXIRI + bevacizumab
IROX
Bolus or infusional 5-FU/leucovorin(Roswell Park regimen)
Simplified biweekly infusional 5-FU/LV (sLV5FU2)
Weekly 
Leucovorin+5FU
Capecitabine
Capecitabine+bevacizumab
Irinotecan
Irinotecan + cetuximab (KRAS/NRAS WT only
Cetuximab (KRAS/NRAS WT only)
Panitumumab (KRAS/NRAS WT only)
Regorafenib
Trifluridine + tipiracil
Pembrolizumab
Nivolumab

Question 2

Describe mFOLFOX6

Answer 2

Oxaliplatin 85 mg/m2 IV day 1
Leucovorin 400 mg/m2 IV day 1
5-FU 400 mg/m2 IV bolus on day 1, then 1200 mg/m2/d x 2 days (total 2400 mg/m2 over 46–48 hours)† IV continuous infusion
Repeat every 2 weeks

Question 3

Describe CAPEOX

Answer 3

Oxaliplatin 130 mg/m2 IV day 1
Capecitabine 1000mg/m2 twice daily PO for 14 days
Repeat every 3 weeks

Question 4

Describe FOLFIRI

Answer 4

Irinotecan 180 mg/m2 IV over 30–90 minutes, day 1
Leucovorin 400 mg/m2 IV infusion to match duration of irinotecan infusion, day 1
5-FU 400 mg/m2 IV bolus day 1, then 1200 mg/m2/d x 2 days (total 2400 mg/m2 over 46–48 hours) continuous infusion
Repeat every 2 weeks