The Role of Folinic Acid in Combination with 5-Fluorouracil in the Treatment of Advanced Colorectal Cancer

In recently published articles the ‘Bundesinstitut für Arzneimittel und Medizin-produkte’ described the combination of 5-FU and folinic acid as a dangerous and experimental treatment for metastatic colorectal cancer, which is not superior to 5-FU alone. This statement is wrong and contradictory to the current oncologic opinion. The careful analysis of relevant study results clearly shows that the combination of 5-FU and folinic acid should be considered as the standard therapy for patients with metastatic colorectal cancer outside of clinical trials. 5-FU plus folinic acid is associated with a higher therapeutic index compared to 5-FU alone, leading to a better tumor control and relief of tumor-related symptoms. In the hand of experienced physicians 5-FU plus folinic acid is a safe treatment and not more toxic than 5-FU alone if dose modification guidelines are strictly followed.