FOLFIRINOX Induction Therapy for Stage 3 Pancreatic Adenocarcinoma
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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.
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.
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.
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.
KeywordsGemcitabine Induction Therapy Objective Response Rate Pancreatic Ductal Adenocarcinoma Resectable Disease
This study was funded in part by NIH/NCI Cancer Center Support Grant P30 CA008748.
There are no conflicts of interest.
- 11.Leone F, Gatti M, Massucco P, et al. Induction gemcitabine and oxaliplatin therapy followed by a twice-weekly infusion of gemcitabine and concurrent external-beam radiation for neoadjuvant treatment of locally advanced pancreatic cancer: a single institutional experience. Cancer. 2013;119:277–84.CrossRefPubMedGoogle Scholar
- 15.National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology, Version 1.2014. http://www.nccn.org//professionals/physician_gls/pdf/pancreatic.pdf. Accessed 10 Feb 2014.
- 17.National Cancer Institute. Cancer Therapy Evaluation Program. Common Toxicity Criteria Manual, Version 4.0. http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf. Accessed 20 Feb 2014.