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Comparison of FOLFIRINOX Chemotherapy with Other Regimens in Patients with Biliary Tract Cancers: a Retrospective Study

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Abstract

Purpose

The aim of this retrospective study was to compare the different treatment options of patients with advanced biliary tract carcinoma (BTC) who were treated with platinum-gemcitabine (CG) or platinum-5-fluorouracil (CF) or 5-Fluorouracil-oxaliplatin-irinotecan (FOLFIRINOX) chemotherapy.

Methods

We included the patients with advanced BTC who were registered at the Department of Oncology in Gaziantep University between January 2008 and January 2016. The following data were analyzed: disease control rate (DCR), progression free survival (PFS) of first and second-line of chemotherapy, and overall survival (OS). Kaplan–Meier method and Log-rank test was used to compare two survival curves, and hazard regression model was used to evaluate risk factors for PFS.

Result

Ninety-two patients were recruited. 53 (57.6 %), 27 (29.3 %), and 12 (13 %) patients received CG, CF, and FOLFIRINOX regimen as first-line chemotherapy, respectively. Median PFS and DCR of CG group were 22 weeks and 56.6 %, and these were 12 weeks and 44.4 % for CF group, and 9 weeks and 41.7 % for FOLFIRINOX group. Median OS of CG, CF, and FOLFIRINOX groups was 28, 21,and 23.5 weeks, respectively (p = 0.497). Second-line PFS of fluoropyrimidine-based chemotherapy group and gemcitabine-based chemotherapy group was 12 vs. 14 weeks (p = 0.988). Second-line PFS of FOLFIRINOX was 20 weeks, whereas it was 14 weeks for other fuoropyrimidine-based chemotherapies (p = 0.190).

Conclusions

This was the first study evaluating the FOLFIRINOX regimen in BTC. Cisplatin-gemcitabine therapy still provides better survival in BCT. However, FOLFIRINOX can be an option in the second-line treatment of BTC patients who are eligible for chemotherapy.

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References

  1. Sharma A, Dwary AD, Mohanti BK, et al. Best supportive care compared with chemotherapy for unresectable gall bladder cancer: a randomized controlled study. J Clin Oncol. 2010;28:4581–6.

    Article  CAS  PubMed  Google Scholar 

  2. DeOliveira ML, Cunningham SC, Cameron JL, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245:755–62.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Valle J, Wasan H, Palmer DH, et al. ABC-02 trial investigators. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362:1273–81.

    Article  CAS  PubMed  Google Scholar 

  4. Okusaka T, Nakachi K, Fukutomi A, et al. Gemcitabine alone or in combination with cisplatinin patients with biliary tract cancer: a comparative multicentre study in Japan. Br J Cancer. 2010;103:469–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Meyerhardt JA, Zhu AX, Stuart K, et al. Phase-II study of gemcitabine and cisplatin in patients with metastatic biliary and gallbladder cancer. Dig Dis Sci. 2008;53:564–70.

    Article  CAS  PubMed  Google Scholar 

  6. Doval DC, Sekhon JS, Gupta SK, et al. A phase II study of gemcitabine and cisplatin in chemotherapy-naive, unresectable gall bladder cancer. Br J Cancer. 2004;90:1516–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Kim ST, Park JO, Lee J, et al. A phase II study ofgemcitabine and cisplatin in advanced biliary tract cancer. Cancer. 2006;106:1339–46.

    Article  CAS  PubMed  Google Scholar 

  8. Cassier PA, Thevenet C, Walter T, et al. Outcome of patients receiving chemotherapy for advanced biliary tract or gallbladder carcinoma. Eur J Gastroenterol Hepatol. 2010;22:1111–7.

    Article  CAS  PubMed  Google Scholar 

  9. Cho JY, Nam JS, Park MS, et al. A phase II study of capecitabine combined with gemcitabine in patients with advanced gallbladder carcinoma. Yonsei Med J. 2005;31(46):526–31.

    Article  Google Scholar 

  10. Iyer RV, Gibbs J, Kuvshinoff B, et al. A phase II study of gemcitabine and capecitabine in advanced cholangiocarcinoma and carcinoma of the gallbladder: a single-institution prospective study. Ann Surg Oncol. 2007;14:3202–9.

    Article  PubMed  Google Scholar 

  11. Knox JJ, Hedley D, Oza A, et al. Combining gemcitabine and capecitabine in patients with advanced biliary cancer: a phase II trial. J Clin Oncol. 23:2332–8.

  12. Wang Y, Hu GF, QQ Z, et al. Efficacy and safety of gemcitabine plus erlotinib for locally advanced or metastatic pancreatic cancer: a systematic review and meta-analysis. Drug Des Devel Ther. 2016;10:1961–72.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Sohal DP, Mangu PB, Khorana AA, et al. Metastatic pancreatic cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2016:JCO671412.

  14. Suker M, Beumer BR, Sadot E, et al. FOLFIRINOX for locally advanced pancreatic cancer: a systematic review and patient-level meta-analysis. Lancet Oncol. 2016;17:801–10.

    Article  CAS  PubMed  Google Scholar 

  15. Ulahannan SV, Rahma OE, Duffy AG, et al. Identification of active chemotherapy regimens in advanced biliary tract carcinoma: a review of chemotherapy trials in the past two decades. Hepat Oncol. 2015;2:39–50.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Park JO, DY O, Hsu C, et al. Gemcitabine plus cisplatin for advanced biliary tract cancer: a systematic review. Cancer Res Treat. 2015;47:343–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Valle JW, Furuse J, Jitlal M, et al. Cisplatin and gemcitabine for advanced biliary tract cancer: a meta-analysis of two randomised trials. Ann Oncol. 2014;25:391–8.

    Article  CAS  PubMed  Google Scholar 

  18. Croitoru A, Gramaticu I, Dinu I, et al. Fluoropyrimidines plus cisplatin versus gemcitabine/gemcitabine plus cisplatinin locally advanced and metastatic biliary tract carcinoma—a retrospective study. J Gastrointestin Liver Dis. 2012;21:277–84.

    PubMed  Google Scholar 

  19. Kim MJ, DY O, Lee SH, et al. Gemcitabine-based versus fluoropyrimidine-based chemotherapy with or without platinum in unresectable biliary tract cancer: a retrospective study. BMC Cancer. 2008;8:374.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Woo SM, Lee WJ, Kim JH, et al. Gemcitabine plus cisplatin versus capecitabine plus cisplatin as first-line chemotherapy for advanced biliary tract cancer: a retrospective cohort study. Chemotherapy. 2013;59:232–8.

    Article  CAS  PubMed  Google Scholar 

  21. Wagner AD, Buechner-Steudel P, Moehler M, et al. Gemcitabine, oxaliplatin and 5-FU in advanced bile duct and gallbladder carcinoma: two parallel, multicentre phase-II trials. Br J Cancer. 2009;101:1846–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Jang JS, Lim HY, Hwang IG, et al. Gemcitabine and oxaliplatin in patients with unresectable biliary cancer including gall bladder cancer: a Korean cancer study group phase II trial. Cancer Chemother Pharmacol. 2010;65:641–7.

    Article  CAS  PubMed  Google Scholar 

  23. Nehls O, Oettle H, Hartmann JT, et al. Capecitabine plus oxaliplatin as first-line treatment in patients with advanced biliary system adenocarcinoma: a prospective multicentre phase II trial. Br J Cancer. 2008;98:309–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. He S, Shen J, Sun X, Liu L, Dong JA. Phase II FOLFOX-4 regimen as second-line treatment in advanced biliary tract cancer refractory to gemcitabine/cisplatin. J Chemother. 2014;26:243–7.

    Article  CAS  PubMed  Google Scholar 

  25. Karachaliou N, Polyzos A, Kentepozidis N, et al. A multicenter phase II trial with irinotecan plus oxaliplatin as first-line treatment for inoperable/metastatic cancer of the biliary tract. Oncology. 2010;78:356–60.

    Article  CAS  PubMed  Google Scholar 

  26. Chung MJ, Kim YJ, Park JY, et al. Prospective phase II trial of gemcitabine in combination with irinotecan as first-line chemotherapy in patientswith advanced biliary tract cancer. Chemotherapy. 2011;57:236–43.

    Article  CAS  PubMed  Google Scholar 

  27. Carriaga MT, Henson DE. Liver, gallbladder, extrahepatic bile ducts, and pancreas. Cancer. 1995;75:171–90.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Medical Oncology, University of Gaziantep, Gaziantep Oncology Hospital, 27310, Gaziantep, TR, Turkey

    Tulay Kus, Gokmen Aktas, Mehmet Emin Kalender, Alper Sevinc & Celaletdin Camci

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  1. Tulay Kus
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  2. Gokmen Aktas
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  3. Mehmet Emin Kalender
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  4. Alper Sevinc
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Correspondence to Tulay Kus.

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Kus, T., Aktas, G., Kalender, M.E. et al. Comparison of FOLFIRINOX Chemotherapy with Other Regimens in Patients with Biliary Tract Cancers: a Retrospective Study. J Gastrointest Canc 48, 170–175 (2017). https://doi.org/10.1007/s12029-016-9880-y

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  • DOI: https://doi.org/10.1007/s12029-016-9880-y

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