Synopsis

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

Folinic acid (also known as leucovorin) is scientifically validated for use in conjunction with certain chemotherapy agents, particularly methotrexate and 5-fluorouracil (5-FU). Folinic acid is not the same as folic acid; it is a form of vitamin B9 that can bypass the blockage of folate metabolism caused by methotrexate. In high-dose methotrexate therapy, methotrexate inhibits dihydrofolate reductase, leading to toxicity in normal cells. Folinic acid "rescues" normal cells by replenishing reduced folate pools, thereby reducing the drug's toxic side effects, especially on the bone marrow and gastrointestinal tract, without diminishing its anti-tumor efficacy. This use, termed "leucovorin rescue," is well-established and supported by decades of clinical studies and oncology guidelines.

Additionally, folinic acid is used to potentiate the effect of 5-FU in colorectal cancer treatment. It stabilizes the binding of 5-FU to thymidylate synthase, enhancing the cytotoxic effect on cancer cells. Both of these uses are recommended by major oncology authorities (e.g., NCCN, ESMO) and are considered standard of care. The evidence base includes numerous randomized controlled trials, systematic reviews, and long-term clinical experience, giving this practice the highest rating for scientific support.

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