OBJECTIVES: FOLFIRINOX (5-fluorouracil [5-FU], oxaliplatin, and irinotecan) as compared with gemcitabine in pancreatic cancer (PC) has superior activity and increased toxicity. The bolus 5-FU contributes to the toxicity. We hypothesized that the elimination of bolus 5-FU and use of hematopoietic growth factor will improve the safety profile without compromising the activity of FOLFIRINOX. METHODS: Sixty patients with PC treated with modified FOLFIRINOX (no bolus 5-FU) were reviewed. Patients were divided into metastatic or nonmetastatic (locally advanced or borderline resectable) disease. Toxicity, response rate, progression-free survival, and overall survival were evaluated. RESULTS: Nonmetastatic and metastatic disease were present in 24 (40%) and 36 (60%) patients, respectively. The incidence of grade 4 neutropenia, grade 3/4 diarrhea, and fatigue were 3%, 13%, and 13%, respectively. Response rate was 30%. The median progression-free survival for nonmetastatic disease was 13.7 months (95% confidence interval [CI], 9.6-24.6 months), and that for metastatic disease was 8.5 months (95% CI, 3.7-11.0 months), respectively. The median overall survival for nonmetastatic disease was 17.8 months (95% CI, 9.9 months to not estimable), and that for metastatic disease was and 9.0 months (95% CI, 7.1 months to not estimable), respectively. CONCLUSIONS: Modified FOLFIRINOX has an improved safety profile with maintained efficacy in metastatic PC. Modified FOLFIRINOX has promising activity in nonmetastatic disease.
OBJECTIVES:FOLFIRINOX (5-fluorouracil [5-FU], oxaliplatin, and irinotecan) as compared with gemcitabine in pancreatic cancer (PC) has superior activity and increased toxicity. The bolus 5-FU contributes to the toxicity. We hypothesized that the elimination of bolus 5-FU and use of hematopoietic growth factor will improve the safety profile without compromising the activity of FOLFIRINOX. METHODS: Sixty patients with PC treated with modified FOLFIRINOX (no bolus 5-FU) were reviewed. Patients were divided into metastatic or nonmetastatic (locally advanced or borderline resectable) disease. Toxicity, response rate, progression-free survival, and overall survival were evaluated. RESULTS: Nonmetastatic and metastatic disease were present in 24 (40%) and 36 (60%) patients, respectively. The incidence of grade 4 neutropenia, grade 3/4 diarrhea, and fatigue were 3%, 13%, and 13%, respectively. Response rate was 30%. The median progression-free survival for nonmetastatic disease was 13.7 months (95% confidence interval [CI], 9.6-24.6 months), and that for metastatic disease was 8.5 months (95% CI, 3.7-11.0 months), respectively. The median overall survival for nonmetastatic disease was 17.8 months (95% CI, 9.9 months to not estimable), and that for metastatic disease was and 9.0 months (95% CI, 7.1 months to not estimable), respectively. CONCLUSIONS: Modified FOLFIRINOX has an improved safety profile with maintained efficacy in metastatic PC. Modified FOLFIRINOX has promising activity in nonmetastatic disease.
Authors: Smita S Joshi; Daniel V T Catenacci; Theodore G Karrison; Jaclyn D Peterson; Mark M Zalupski; Amikar Sehdev; James Wade; Ahad Sadiq; Vincent J Picozzi; Andrea Amico; Robert Marsh; Mark F Kozloff; Blase N Polite; Hedy L Kindler; Manish R Sharma Journal: Clin Cancer Res Date: 2019-09-26 Impact factor: 12.531
Authors: Mustafa Suker; Berend R Beumer; Eran Sadot; Lysiane Marthey; Jason E Faris; Eric A Mellon; Bassel F El-Rayes; Andrea Wang-Gillam; Jill Lacy; Peter J Hosein; Sing Yu Moorcraft; Thierry Conroy; Florian Hohla; Peter Allen; Julien Taieb; Theodore S Hong; Ravi Shridhar; Ian Chau; Casper H van Eijck; Bas Groot Koerkamp Journal: Lancet Oncol Date: 2016-05-06 Impact factor: 41.316
Authors: Maeve A Lowery; Ryan Ptashkin; Emmet Jordan; Michael F Berger; Ahmet Zehir; Marinela Capanu; Nancy E Kemeny; Eileen M O'Reilly; Imane El-Dika; William R Jarnagin; James J Harding; Michael I D'Angelica; Andrea Cercek; Jaclyn F Hechtman; David B Solit; Nikolaus Schultz; David M Hyman; David S Klimstra; Leonard B Saltz; Ghassan K Abou-Alfa Journal: Clin Cancer Res Date: 2018-05-30 Impact factor: 12.531
Authors: Davendra P S Sohal; Pamela B Mangu; Alok A Khorana; Manish A Shah; Philip A Philip; Eileen M O'Reilly; Hope E Uronis; Ramesh K Ramanathan; Christopher H Crane; Anitra Engebretson; Joseph T Ruggiero; Mehmet S Copur; Michelle Lau; Susan Urba; Daniel Laheru Journal: J Clin Oncol Date: 2016-05-31 Impact factor: 44.544
Authors: Jonathan D Mizrahi; Jane E Rogers; Kenneth R Hess; Robert A Wolff; Gauri R Varadhachary; Milind M Javle; Rachna T Shroff; Linus Ho; David R Fogelman; Kanwal P S Raghav; Michael J Overman; Shubham Pant Journal: Pancreatology Date: 2020-01-09 Impact factor: 3.996