Does OPTIMOX strategy ("stop-and-go" approach) also work in treatment of pancreatic cancer with oxaliplatin-based regimens?

A recent pooled analysis and a meta-analysis suggested a survival benefit of gemcitabine-platinum doublets when compared with single agent gemcitabine. Sensory neurotoxicity is a potentially limiting toxicity associated with oxaliplatin therapy. Because neuromodulatory agents have shown rather disappointing activity in the prevention of oxaliplatin-induced neurotoxicity, the so-called OPTIMOX (stop and go) approach offers a reasonable strategy when oxaliplatin-based therapy is used in the palliative setting. This strategy seems to be successful when used as a first-line approach, rather than being held in reserve until chemotherapy based on another agent fails in patients with metastatic colorectal cancer. However, no data exists to support OPTIMOX strategy in pancreatic cancer. We here describe the first report of a patient with metastatic pancreatic cancer in whom OPTIMOX strategy allows her to manage the toxicity as well as achieve long-term disease control.