FOLFIRI plus the targeted antibody cetuximab. On top of FOLFIRI's diarrhea and low counts, expect an acne-like rash on the face and upper body within the first couple of weeks.
FOLFIRI (every 2 weeks) plus the antibody cetuximab. Cetuximab adds a distinctive acne-like rash that appears in the first 1-2 weeks, plus low magnesium. Only used for RAS wild-type tumors.
Get help straight away — this is true on any regimen, on any day.
A temperature of 100.4°F (38°C) or higher during treatment can mean a
serious infection while your blood counts are low. Call your team or go to the ER — do not
wait it out.
Also urgent: trouble breathing or chest pain · swelling of the face, lips or throat ·
new confusion or fainting · shaking chills · not being able to keep fluids down.
This is standing guidance shown to everyone. Nothing on this page is based on anything
about you, and nobody is monitoring you.
Timed to the cycle
Day 1 is the day of your infusion. These are the effects a retrievable
document ties to a day range for this regimen — not a prediction about you.
Infusion reaction
During or just after an infusion
A reaction during the first infusion (fever, chills, flushing, rarely trouble breathing). You'll get pre-medication and be watched closely; most reactions are mild.
Call your team urgently: Any trouble breathing, throat tightness, or dizziness during the infusion — tell staff at once.
reported by about 15-20% of people; severe in 2-5% · Timing is part of what this effect is · from Cetuximab
Late-onset diarrhea
Typically around days 5–11
Diarrhea (often from about day 5) that can be worsened by the combination. Start loperamide at the first loose stool and hydrate; call your team if it escalates.
Call your team urgently: More than 6 stools above normal, diarrhea with fever, or any with lightheadedness — call urgently.
reported by about ~65% of people; severe in 15-16% · Timing from the manufacturer’s prescribing information · from Irinotecan, Cetuximab
Neutropenia
Typically around days 8–27
A temporary drop in infection-fighting white cells.
Call your team urgently: A temperature of 100.4°F (38.0°C) or higher — an emergency.
reported by about ~50% of people; severe in 24-31% · Timing from a drug-monograph reference · from Irinotecan, Fluorouracil
Not tied to a cycle day
These build with the number of doses, or are measured from when treatment started, so a cycle day would be the wrong shape for them. Each keeps the timing its own source states.
Acneiform rash
first 1-2 weeks
An acne-like rash on the face, scalp, chest, and back — a sign the drug is working on skin cells. It usually appears in the first 1-2 weeks. Gentle skin care, sun protection, and sometimes antibiotics/creams help; tell your team early.
Call your team: Rash with widespread blistering, peeling, or signs of skin infection (pus, spreading redness).
reported by about 86% of people; severe in 18% · from Cetuximab
Low magnesium (hypomagnesemia)
builds over weeks of treatment
Cetuximab can make the kidneys waste magnesium. Low levels can cause cramps, tiredness, or tingling. Your team checks bloodwork and may give magnesium replacement.
reported by about ~30% of people; severe in 5-6% · from Cetuximab
Where this comes from
S1. Van Cutsem E, CRYSTAL trial (FOLFIRI ± cetuximab) (2009) — PMID 19339720
S2. Cetuximab (Erbitux) FDA prescribing information — FDA label
S3. Irinotecan (Camptosar) FDA prescribing information — FDA label
Timing windows on this page rest on:
Camptosar (irinotecan) FDA prescribing information — “the median time to the onset of late diarrhea was 5 days with 3-week dosing and 11 days with weekly dosing” source
BC Cancer Drug Manual — irinotecan — “350 mg/m2 q3wk: nadir 8-9 days; 125 mg/m2 weekly: nadir 15-27 days” source
Definitional — an infusion reaction is one that occurs during or shortly after the infusion — “The timing is part of what the term denotes; there is no empirical claim here to source.”
A window appears here only where a retrievable document ties it to a drug in
this regimen. Where nothing could be found, the window was removed rather than estimated —
so a missing time is an honest gap, not an oversight.