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Annals of Surgical Oncology

, Volume 22, Issue 11, pp 3512–3521 | Cite as

FOLFIRINOX Induction Therapy for Stage 3 Pancreatic Adenocarcinoma

  • Eran Sadot
  • Alexandre Doussot
  • Eileen M. O’Reilly
  • Maeve A. Lowery
  • Karyn A. Goodman
  • Richard Kinh Gian Do
  • Laura H. Tang
  • Mithat Gönen
  • Michael I. D’Angelica
  • Ronald P. DeMatteo
  • T. Peter Kingham
  • William R. Jarnagin
  • Peter J. AllenEmail author
Pancreatic Tumors

Abstract

Background

Reports show that FOLFIRINOX therapy for pancreatic ductal adenocarcinoma (PDAC) results in objective response rates two to threefold higher than those of other regimens. This study aimed to assess response and resection rates for locally unresectable (stage 3) patients initially treated with induction FOLFIRINOX.

Methods

The institutional cancer database was queried for patients treated with induction FOLFIRINOX therapy between 2010 and 2013. Patients were included in the study if they were treated at the authors’ institution for stage 3 PDAC (locally unresectable) that had been adjudicated at a weekly multidisciplinary tumor board.

Results

The study identified 101 patients. The median age was 64 years (range 37–81 years), and the median follow-up period was 12 months (range 3–37 months). The patients received a median of six cycles (range 1–20 cycles) of induction FOLFIRINOX. No grade 4 or 5 toxicity was recorded. At the initial restaging (median of 3 months after diagnosis), 23 patients (23 %) had developed distant metastases, 15 patients (15 %) had undergone resection, and 63 patients (63 %) had proceeded to chemoradiation. In the group of 63 patients who had proceeded to chemoradiation (median of 9 months after diagnosis), an additional 16 patients (16 %) had undergone resection, and 5 patients (5 %) had developed metastases. A partial radiographic response was observed in 29 % of all the patients, which was associated with ability to perform resection (p = 0.004). The median overall survival time was 11 months for the group that progressed with FOLFIRINOX and 26 months for the group that did not progress.

Conclusion

Nearly one third of the patients who had been initially identified as having stage 3 pancreatic carcinoma and had been treated with FOLFIRINOX responded radiographically and underwent tumor resection.

Keywords

Gemcitabine Induction Therapy Objective Response Rate Pancreatic Ductal Adenocarcinoma Resectable Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This study was funded in part by NIH/NCI Cancer Center Support Grant P30 CA008748.

Disclosure

There are no conflicts of interest.

Supplementary material

10434_2015_4647_MOESM1_ESM.doc (140 kb)
Supplementary material 1 (DOC 139 kb)

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Eran Sadot
    • 1
  • Alexandre Doussot
    • 1
  • Eileen M. O’Reilly
    • 2
  • Maeve A. Lowery
    • 2
  • Karyn A. Goodman
    • 3
  • Richard Kinh Gian Do
    • 4
  • Laura H. Tang
    • 5
  • Mithat Gönen
    • 6
  • Michael I. D’Angelica
    • 1
  • Ronald P. DeMatteo
    • 1
  • T. Peter Kingham
    • 1
  • William R. Jarnagin
    • 1
  • Peter J. Allen
    • 1
    Email author
  1. 1.Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of Radiation OncologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  5. 5.Department of PathologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  6. 6.Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkUSA

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