Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

FOLFOXIRI with bevacizumab in metastatic bowel cancer

Three chemotherapy drugs with bevacizumab for young, fit patients (TRIBE)

Updated: 28 October 20261 min read3 references

Summary for doctors

  • Metastatic colorectal cancer in fit patients aged 75 or under, especially BRAF-mutant disease or to shrink the tumour for surgery [1].
  • More toxicity (neutropenia, diarrhoea, neuropathy) [1].

Dose and schedule

FOLFOXIRI + bevacizumab

Metastatic colorectal cancer, first lineCycle length: Every 14 days

Metastatic colorectal cancer, first line

DrugDoseRouteSchedule
Bevacizumab5 mg/kgIVDay 1
Irinotecan165 mg/m²IV over 60 minutesDay 1
Oxaliplatin85 mg/m²IV over 2 hoursDay 1
Leucovorin200 mg/m²IV over 2 hoursDay 1
Fluorouracil3200 mg/m²Continuous 48-hour infusionStarting on day 1
Cycle length
Every 14 days
Duration
Up to 12 cycles, then maintenance fluorouracil and bevacizumab

As in TRIBE [1].

Dose source: [3].

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • DPYD [2]; atropine and loperamide as for FOLFIRI; consider G-CSF prophylaxis.
  • Bevacizumab: blood pressure and urine protein; stop 6 weeks before and after major surgery.

Monitoring and dose adjustment

  • Blood counts before each cycle; grade 3 to 4 diarrhoea and neutropenia are more common than with FOLFIRI.

Main evidence

Show detailsHide

TRIBE: median progression-free survival 12.1 vs 9.7 months and median overall survival 29.8 vs 25.8 months compared with FOLFIRI-bevacizumab [1].

Related cancer types

Colorectal cancer

Treatment regimens (physicians)

FOLFOX (mFOLFOX6): dose, schedule and side effectsCAPOX (XELOX): dose, schedule and side effectsFOLFIRI regimen: dose, schedule and side effectsTotal neoadjuvant therapy (TNT) in rectal cancer: the RAPIDO regimen

Physician tools and lessons

Colon Cancer TNM Staging Calculator (AJCC 8th Edition)10 cheap steps that save patients' livesGermline genetic testing in cancer: who, and which genes?

References

3 references
Show all references, 1 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancerLoupakis F, Cremolini C, Masi G, et al · N Engl J Med · 2014;371:1609-18
    DOIPubMed Back to text: 1 2 3 4
  2. 2
    Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Dihydropyrimidine Dehydrogenase Genotype and Fluoropyrimidine Dosing: 2017 UpdateAmstutz U, Henricks LM, Offer SM, et al · Clin Pharmacol Ther · 2018;103:210-216
    Study cardDOIPubMed Back to text
  3. 3
    Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord OvestFalcone A, Ricci S, Brunetti I, et al · J Clin Oncol · 2007;25:1670-6
    DOIPubMed Back to text

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/folfoxiri-bevacizumab/

Related pages

27 October 2026 FOLFOX (mFOLFOX6): dose, schedule and side effects Dose and schedule of mFOLFOX6 (oxaliplatin 85, leucovorin 400, fluorouracil 400 bolus and 2400 as a 46-hour infusion), length of adjuvant treatment, premedication, neuropathy and dose adjustment. 27 October 2026 CAPOX (XELOX): dose, schedule and side effects Dose and schedule of CAPOX or XELOX (oxaliplatin 130 and capecitabine 1000 twice daily, days 1 to 14), length of adjuvant treatment, renal adjustment and side effects. 27 October 2026 FOLFIRI regimen: dose, schedule and side effects Dose and schedule of FOLFIRI (irinotecan 180, leucovorin 400, fluorouracil 400 bolus and 2400 as a 46-hour infusion), diarrhoea control, UGT1A1 and dose adjustment.