Neo-adjuvant FOLFIRINOX in borderline resectable and locally advanced pancreatic adenocarcinoma Journal Article
| Authors: | Temraz, S.; Nassar, F.; Hammoud, M. S.; Mukherji, D.; O'Reilly, E. M.; Dbouk, H.; Farhat, F.; Charafeddine, M.; Faraj, W.; Khalifeh, M. J.; Abou-Alfa, G. K.; Shamseddine, A. |
| Article Title: | Neo-adjuvant FOLFIRINOX in borderline resectable and locally advanced pancreatic adenocarcinoma |
| Abstract: | Background: Surgery and systemic therapy provide the best option for long-term cancer control in localized resectable pancreas cancer. The present study assessed the efficacy and safety of neoadjuvant treatment with FOLFIRINOX in patients with borderline resectable (BR) and locally advanced (LA) pancreas cancer (PDAC). Methods: This was a prospective noninterventional observational trial of neoadjuvant FOLFIRINOX in BR and LA PDAC. The primary objective was the R0/R1 surgical resection rate. Secondary objectives included progression free survival (PFS) and overall survival (OS), tolerability, and toxicity. Results: Forty-nine patients were enrolled between 2013 and 2019; the majority had LA disease (59.2%). Median age was 61 years, and median Ca 19-9 level pretreatment was 523.4 μmol/L. Following neoadjuvant FOLFIRINOX, 11 patients (22.5%) underwent surgical resection, the majority of which were BR at diagnosis (72.7%). Median OS and PFS for the entire group were 25 (95% CI: 17.2–32.8) and 12 months (95% CI: 9.7–13.3), respectively. Median PFS in BR patients was 14 (95% CI: 10.5–17.5) compared to 12 months (95% CI: 5.2–18.8) in patients with LA patients. Median OS and PFS were not reached in patients who underwent surgical resection as compared to 22 (95% CI: 18.6–25.4) and 9 months (95% CI: 4.2–13.9) in those who did not, respectively. Grade 3/4 neutropenia, leukopenia, neuropathy, nausea/vomiting, and diarrhea occurred in 6.3%, 2.1%, 10.4%, 4.2%, and 8.3%, respectively. Conclusion: Neoadjuvant FOLFIRINOX is an active regimen for patients with LA/BR PDAC with a resection rate of 22.5%. These results are in line with prior data. © 2022 John Wiley & Sons Australia, Ltd. |
| Keywords: | survival; adult; clinical article; controlled study; human tissue; aged; middle aged; cancer surgery; overall survival; drug tolerability; fatigue; neutropenia; cancer localization; fluorouracil; advanced cancer; diarrhea; drug dose reduction; drug efficacy; side effect; adjuvant therapy; neoadjuvant therapy; pancreatic neoplasms; antineoplastic agent; prospective study; prospective studies; adenocarcinoma; progression free survival; controlled clinical trial; infection; liver toxicity; multiple cycle treatment; leukopenia; mucosa inflammation; nausea; neuropathy; thrombocytopenia; vomiting; antineoplastic combined chemotherapy protocols; ca 19-9 antigen; cohort analysis; continuous infusion; pathology; irinotecan; confidence interval; folinic acid; pancreas tumor; therapy delay; pancreas adenocarcinoma; neoadjuvant chemotherapy; observational study; oxaliplatin; granulocyte colony stimulating factor; leucovorin; resectability; adverse event; clinical outcome; pancreatic neoplasm; procedures; body weight loss; device safety; humans; human; male; female; article; loss of appetite; folfirinox |
| Journal Title: | Asia-Pacific Journal of Clinical Oncology |
| Volume: | 18 |
| Issue: | 6 |
| ISSN: | 1743-7555 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2022-12-01 |
| Start Page: | 735 |
| End Page: | 742 |
| Language: | English |
| DOI: | 10.1111/ajco.13775 |
| PUBMED: | 35362216 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 January 2023 -- Source: Scopus |
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