Synopsis

Source of validity: Scientific
Rating (out of 5): 5

Folinic acid (also known as leucovorin) is scientifically validated for use in chemotherapy, particularly with methotrexate and 5-fluorouracil (5-FU) regimens. Methotrexate is an antifolate drug that inhibits dihydrofolate reductase, impeding DNA synthesis and cell replication, which affects both cancer and normal cells. Folinic acid is a reduced form of folic acid that bypasses this enzymatic block and "rescues" normal cells from methotrexate toxicity, reducing side effects such as myelosuppression, mucositis, and gastrointestinal toxicity without diminishing the anticancer effects on malignant cells, provided the timing and dosing are carefully managed.

In the context of 5-FU chemotherapy, folinic acid is used not to reduce toxicity, but to enhance the effectiveness of the chemotherapy. It stabilizes the bond between 5-FU and thymidylate synthase, increasing the cytotoxic effect on cancer cells. This combination is a standard of care in several cancers, including colorectal cancer.

Multiple randomized controlled trials and clinical guidelines (such as those from ASCO and NCCN) endorse the use of folinic acid in these contexts, and its utility is well characterized in pharmacology texts. Therefore, there is robust scientific evidence supporting the use of folinic acid both as a "chemoprotectant" (with methotrexate) and as a chemosensitizer (with 5-FU).

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