The Drug-Induced Respiratory Disease Website

FOLFOX chemotherapy regimen

The FOLFOX regimen includes 5-fluorouracil (5-FU), oxaliplatin and folinic acid. It is used in the treatment of colorectal carcinoma. Which drugs in regimen is causal in yet unclear

XXIV - Interstitial lung disease - Pulmonary infiltrates - Pulmonary fibrosis

XXIV.a

Pneumonitis (ILD)

XXIV.h

Pulmonary fibrosis (may improve but partly following drug discontinuation)

XXIV.o

Rapidly progressive ILD/pulmonary fibrosis (Hamman-Rich syndrome)

XXIV.aj

Fatal pulmonary fibrosis

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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