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. 2013 Sep;108(4):236-41.
doi: 10.1002/jso.23392.

Outcomes with FOLFIRINOX for borderline resectable and locally unresectable pancreatic cancer

Brian A Boone  1 , Jennifer Steve, Alyssa M Krasinskas, Amer H Zureikat, Barry C Lembersky, Michael K Gibson, Ronald G Stoller, Herbert J Zeh, Nathan Bahary
Affiliations

Outcomes with FOLFIRINOX for borderline resectable and locally unresectable pancreatic cancer

Brian A Boone et al. J Surg Oncol. 2013 Sep.

Abstract

Background: Trials examining FOLFIRINOX in metastatic pancreatic cancer demonstrate higher response rates compared to gemcitabine-based regimens. There is currently limited experience with neoadjuvant FOLFIRINOX in pancreatic cancer.

Methods: Retrospective review of outcomes of patients with borderline resectable or locally unresectable pancreatic cancer who were recommended to undergo neoadjuvant treatment with FOLFIRINOX.

Results: FOLFIRINOX was recommended for 25 patients with pancreatic cancer, 13 (52%) unresectable and 12 (48%) borderline resectable. Four patients (16%) refused treatment or were lost to follow-up. Twenty-one patients (84%) were treated with a median of 4.7 cycles. Six patients (29%) required dose reductions secondary to toxicity. Two patients (9%) were unable to tolerate treatment and three patients (14%) had disease progression on treatment. Seven patients (33%) underwent surgical resection following treatment with FOLFIRINOX alone, 2 (10%) of which were initially unresectable. Two patients underwent resection following FOLFIRINOX + stereotactic body radiation therapy (SBRT). The R0 resection rate for patients treated with FOLFIRINOX ± SBRT was 33% (55% borderline resectable, 10% unresectable). A total of five patients (24%) demonstrated a significant pathologic response.

Conclusions: FOLFIRINOX is a biologically active regimen in borderline resectable and locally unresectable pancreatic cancer with encouraging R0 resection and pathologic response rates.

Keywords: borderline resectable; locally unresectable; neoadjuvant treatment; pancreatic cancer: FOLFIRINOX.

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Figures

Figure I
Figure I. Flowchart depicted outcomes of patients treated with neoadjuvant FOLFIRINOX for borderline resectable disease (A) and unresectable, locally advanced disease (B)
Figure I
Figure I. Flowchart depicted outcomes of patients treated with neoadjuvant FOLFIRINOX for borderline resectable disease (A) and unresectable, locally advanced disease (B)
See this image and copyright information in PMC

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