When giving FOLFOX/FOLFIRI and skipping 5FU bolus, do you still give leucovorin?

In general, if I am not giving the 5-FU bolus, I will also not give the leucovorin. The purpose of the leucovorin is to increase the time that 5-FU given by bolus binds to thymidylate synthase. Since the 5-FU bolus is being withheld, the leucovorin has limited purpose, as the 5-FU continuous infusio...

I respectfully agree with @Dr. First Last, and this was my belief until recently reviewing this topic. Currently I am not sure.

So taking the other side of the argument, is there clinical data available to convince us otherwise, that LV is still of some benefit in infusional 5FU regimens?

From this st...

The same principle applies to LV with 5FU in liposomal irinotecan for pancreatic cancer.