Original Article

Cancer Chemotherapy and Pharmacology

, Volume 69, Issue 6, pp 1641-1645

First online:

FOLFIRI as second-line chemotherapy for advanced pancreatic cancer: a GISCAD multicenter phase II study

  • Alberto ZaniboniAffiliated withMedical Oncology Unit, Fondazione Poliambulanza Email author 
  • , Enrico AitiniAffiliated withMedical Oncology Unit, C. Poma Hospital
  • , Sandro BarniAffiliated withMedical Oncology Unit, Treviglio-Caravaggio Hospital
  • , Daris FerrariAffiliated withMedical Oncology Unit, S. Paolo Hospital
  • , Stefano CascinuAffiliated withMedical Oncology Unit, Università Politecnica delle Marche, Ospedali Riuniti di Ancona
  • , Vincenzo CatalanoAffiliated withMedical Oncology Unit, Ospedali Riuniti Marche Nord, Presidio San Salvatore
  • , Giuseppe ValmadreAffiliated withMedical Oncology DH, Ospedale di Sondalo
  • , Domenica FerraraAffiliated withMedical Oncology Unit, Ospedale San Carlo
  • , Enzo VeltriAffiliated withMedical Oncology Unit, Ospedale Don Luigi di Liegro
    • , Claudio CodignolaAffiliated withDepartment of Surgery, Fondazione Poliambulanza
    • , Roberto LabiancaAffiliated withMedical Oncology Unit, Ospedali Riuniti

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The purpose of the present study was to evaluate the activity and the tolerability of the FOLFIRI regimen, administered as second-line chemotherapy in patients with locally advanced or metastatic pancreatic cancer after the failure of a gemcitabine-based regimen.


Patients with locally advanced/metastatic disease who received a first-line chemotherapy (one line only) with gemcitabine ± platinoid (cisplatin, oxaliplatin) and who had measurable disease conform with the RECIST criteria were eligible for the study.

FOLFIRI consists of irinotecan 180 mg/m2 iv on day 1, leucovorin (l-form) 200 mg/m2 iv on day 1 and 2, 5-FU 400 mg/m2 iv bolus on days 1 and 2, and 5-FU 600 mg/m2 iv by ci for 22 h on days 1 and 2, repeated every 2 weeks. The primary end point was the response rate.


Among the 50 enrolled patients, 4 partial responses (PR) (8 %) and 14 stable diseases were observed, for a disease control rate of 18/50 (36 %). Forty-one patients (82 %) have been pretreated with cisplatin/oxaliplatin+gemcitabine as first-line chemotherapy. The median progression-free and overall survivals were 3.2 and 5 months, respectively. The 6-month survival rate was 32 %. Grade 3–4 neutropenia and diarrhea occurred in 10 (20 %) and 6 (12 %) patients, respectively.


The FOLFIRI regimen showed a modest clinical activity in this quite heavily pretreated patients’ population with locally advanced or metastatic pancreatic cancer with a manageable toxicity profile.


Pancreatic cancer FOLFIRI Chemotherapy Second-line Irinotecan