Xu-Ya Cui1,2,3,4,5,6, Xue-Chuan Li2,3,4,5,6, Jiu-Jie Cui4,6,7, Xiang-Song Wu1,3,5, Lu Zou2,3,4,5,6, Xiao-Ling Song1,3,5, Tai Ren1,3,5, Yi-Di Zhu1,3,5, Huai-Feng Li1,3,5, Yang Yang2,3,4,5,6, Ke Liu2,3,4,5,6, Xu-Sheng Han1,3,5, Zi-Yao Jia1,3,5, Wen-Guang Wu2,3,4,5,6, Xu-An Wang2,3,4,5,6, Wei Gong1,3,5, Li-Wei Wang4,6,7, Mao-Lan Li1,3,5, Ying-Bin Liu2,3,4,5,6. 1. Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Department of Biliary-Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 3. Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China. 4. State Key Laboratory of Oncogenes and Related Genes, Shanghai, China. 5. Shanghai Research Center of Biliary Tract Disease, Shanghai, China. 6. Shanghai Cancer Institute, Shanghai, China. 7. Department of Medical Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Abstract
BACKGROUND: The first-line chemotherapy regimen for advanced gallbladder cancer (GBC) is gemcitabine plus platinum (GP), despite its efficacy is limited. The current investigation is a retrospective study to compare the safety and efficacy between the modified FOLFIRINOX (mFOLFIRINOX) and gemcitabine plus oxaliplatin (GEMOX) as the first-line chemotherapy for unresectable locally advanced or metastatic GBC. METHODS: The data of patients with unresectable locally advanced or metastatic GBC, who were treated with mFOLFIRINOX or GEMOX as the first-line therapy between April 2014 and April 2018 at Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, were retrieved. This retrospective study evaluated the clinical characteristics, survival outcomes and adverse events. RESULTS: A total of 44 patients (n=25 in mFOLFIRINOX, n=19 in GEMOX) were included. There were no significant differences between groups in baseline characteristics. The median progression free survival (mPFS) was 5.0 months in the mFOLFIRINOX group and 2.5 months in the GEMOX group [P=0.021; hazard ratio (HR), 0.499; 95% CI, 0.266 to 0.937]. The median overall survival (mOS) was 9.5 months in the mFOLFIRINOX group and 7.0 months in the GEMOX group (P=0.019; HR, 0.471; 95% CI, 0.239 to 0.929). Disease control rate (DCR) was 76.0% in the mFOLFIRINOX group and 47.4% in the GEMOX group (P=0.051). The rate of grade 3-4 adverse events was 48% in the mFOLFIRINOX group and 36.8% in the GEMOX group (P=0.459). The incidence of grade 3-4 neutropenia and diarrhea were more common in the mFOLFIRINOX group, while the incidence of grade 3-4 thrombocytopenia and peripheral neuropathy were more common in the GEMOX group. CONCLUSIONS: mFOLFIRINOX might improve the poor prognosis of unresectable locally advanced or metastatic GBC, and the results need to be further verified by prospective clinical studies. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
BACKGROUND: The first-line chemotherapy regimen for advanced gallbladder cancer (GBC) is gemcitabine plus platinum (GP), despite its efficacy is limited. The current investigation is a retrospective study to compare the safety and efficacy between the modified FOLFIRINOX (mFOLFIRINOX) and gemcitabine plus oxaliplatin (GEMOX) as the first-line chemotherapy for unresectable locally advanced or metastatic GBC. METHODS: The data of patients with unresectable locally advanced or metastatic GBC, who were treated with mFOLFIRINOX or GEMOX as the first-line therapy between April 2014 and April 2018 at Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, were retrieved. This retrospective study evaluated the clinical characteristics, survival outcomes and adverse events. RESULTS: A total of 44 patients (n=25 in mFOLFIRINOX, n=19 in GEMOX) were included. There were no significant differences between groups in baseline characteristics. The median progression free survival (mPFS) was 5.0 months in the mFOLFIRINOX group and 2.5 months in the GEMOX group [P=0.021; hazard ratio (HR), 0.499; 95% CI, 0.266 to 0.937]. The median overall survival (mOS) was 9.5 months in the mFOLFIRINOX group and 7.0 months in the GEMOX group (P=0.019; HR, 0.471; 95% CI, 0.239 to 0.929). Disease control rate (DCR) was 76.0% in the mFOLFIRINOX group and 47.4% in the GEMOX group (P=0.051). The rate of grade 3-4 adverse events was 48% in the mFOLFIRINOX group and 36.8% in the GEMOX group (P=0.459). The incidence of grade 3-4 neutropenia and diarrhea were more common in the mFOLFIRINOX group, while the incidence of grade 3-4 thrombocytopenia and peripheral neuropathy were more common in the GEMOX group. CONCLUSIONS: mFOLFIRINOX might improve the poor prognosis of unresectable locally advanced or metastatic GBC, and the results need to be further verified by prospective clinical studies. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
Entities:
Keywords:
Gallbladder cancer (GBC); chemotherapy; gemcitabine plus oxaliplatin (GEMOX); modified FOLFIRINOX (mFOLFIRINOX)
Authors: B Glimelius; K Hoffman; P O Sjödén; G Jacobsson; H Sellström; L K Enander; T Linné; C Svensson Journal: Ann Oncol Date: 1996-08 Impact factor: 32.976
Authors: Juan Valle; Harpreet Wasan; Daniel H Palmer; David Cunningham; Alan Anthoney; Anthony Maraveyas; Srinivasan Madhusudan; Tim Iveson; Sharon Hughes; Stephen P Pereira; Michael Roughton; John Bridgewater Journal: N Engl J Med Date: 2010-04-08 Impact factor: 91.245
Authors: T André; C Tournigand; O Rosmorduc; S Provent; F Maindrault-Goebel; D Avenin; F Selle; F Paye; L Hannoun; S Houry; B Gayet; J P Lotz; A de Gramont; C Louvet Journal: Ann Oncol Date: 2004-09 Impact factor: 32.976
Authors: E A Eisenhauer; P Therasse; J Bogaerts; L H Schwartz; D Sargent; R Ford; J Dancey; S Arbuck; S Gwyther; M Mooney; L Rubinstein; L Shankar; L Dodd; R Kaplan; D Lacombe; J Verweij Journal: Eur J Cancer Date: 2009-01 Impact factor: 9.162
Authors: Rachna T Shroff; Milind M Javle; Lianchun Xiao; Ahmed O Kaseb; Gauri R Varadhachary; Robert A Wolff; Kanwal P S Raghav; Michiko Iwasaki; Peter Masci; Ramesh K Ramanathan; Daniel H Ahn; Tanios S Bekaii-Saab; Mitesh J Borad Journal: JAMA Oncol Date: 2019-06-01 Impact factor: 31.777
Authors: Sang Myung Woo; Sang Hyub Lee; Ji Won Yoo; Ki Young Yang; Jung Gyun Seo; Joo Kyung Park; Jin-Hyeok Hwang; Woo Jin Lee; Ji Kon Ryu; Yong-Tae Kim; Yong Bum Yoon Journal: Gut Liver Date: 2013-06-11 Impact factor: 4.519
Authors: Stacey M Stein; Edward S James; Yanhong Deng; Xiangyu Cong; Jeremy S Kortmansky; Jia Li; Carol Staugaard; Doddamane Indukala; Ann Marie Boustani; Vatsal Patel; Charles H Cha; Ronald R Salem; Bryan Chang; Howard S Hochster; Jill Lacy Journal: Br J Cancer Date: 2016-03-29 Impact factor: 7.640