FOLFIRINOX induction therapy for stage 3 pancreatic adenocarcinoma Journal Article

Authors: Sadot, E.; Doussot, A.; O'Reilly, E. M.; Lowery, M. A.; Goodman, K. A.; Do, R. K. G.; Tang, L. H.; Gönen, M.; D'Angelica, M. I.; DeMatteo, R. P.; Kingham, T. P.; Jarnagin, W. R.; Allen, P. J.
Article Title: FOLFIRINOX induction therapy for stage 3 pancreatic adenocarcinoma
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. © 2015, Society of Surgical Oncology.
Keywords: adult; aged; cancer surgery; major clinical study; overall survival; fluorouracil; unspecified side effect; gemcitabine; cancer radiotherapy; cancer staging; follow up; multiple cycle treatment; data base; distant metastasis; irinotecan; postoperative complication; folinic acid; drug response; pancreas adenocarcinoma; radiography; toxicity; oxaliplatin; chemoradiotherapy; induction chemotherapy; very elderly; human; male; female; article
Journal Title: Annals of Surgical Oncology
Volume: 22
Issue: 11
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2015-10-01
Start Page: 3512
End Page: 3521
Language: English
DOI: 10.1245/s10434-015-4647-4
PROVIDER: scopus
PUBMED: 26065868
PMCID: PMC4849545
Notes: Export Date: 2 October 2015 -- Source: Scopus
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MSK Authors
  1. Ronald P DeMatteo
    602 DeMatteo
  2. Karyn A Goodman
    245 Goodman
  3. Mithat Gonen
    716 Gonen
  4. Maeve Aine Lowery
    98 Lowery
  5. Peter Allen
    442 Allen
  6. William R Jarnagin
    596 Jarnagin
  7. Kinh Gian Do
    116 Do
  8. T Peter Kingham
    293 Kingham
  9. Laura Hong Tang
    328 Tang
  10. Eileen O'Reilly
    324 O'Reilly
  11. Eran Sadot
    36 Sadot
  12. Alexandre Florent Doussot
    15 Doussot