Pancreatic cancer and FOLFIRINOX: a new era and new questions
- PMID: 25693729
- PMCID: PMC4472208
- DOI: 10.1002/cam4.433
Pancreatic cancer and FOLFIRINOX: a new era and new questions
Abstract
FOLFIRINOX (FFX) was introduced to clinical practice in 2010 following publication of the PRODIGE 4/ACCORD 11 study, which compared this novel regimen to gemcitabine in metastatic pancreatic cancer. Median overall survival, progression-free survival, and objective responses were all superior with FFX and there was improved time to definitive deterioration in quality of life. Despite initial concerns over toxicity, there has been rapid uptake of this regimen, both revolutionizing management and opening the door to innovative research. As experience with FFX has accrued, many questions have arisen including the management of toxicities, the impact of frequent modifications, the optimal number of cycles, integration with other regimens and modalities, interpretation of radiologic and serologic response, utility of molecular signatures, and potential benefit in unique clinical settings such as pre- and postsurgery. This review will closely examine these issues, not only to summarize current knowledge but also to fuel scientific debate.
Keywords: Chemotherapy; FOLFIRINOX; genomics; modifications; pancreatic cancer; toxicity.
© 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
References
-
- Moore MJ, Goldstein D, Hamm J, Figer A, Hecht JR, Gallinger S, et al. Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J. Clin. Oncol. 2007;25:1960–1966. - PubMed
-
- Cunningham D, Chau I, Stocken DD, Valle JW, Smith D, Steward W, et al. Phase III randomized comparison of gemcitabine versus gemcitabine plus capecitabine in patients with advanced pancreatic cancer. J. Clin. Oncol. 2009;27:5513–5518. - PubMed
-
- Fine RL, Fogelman DR, Schreibman SM, Desai M, Sherman W, Strauss J, et al. The gemcitabine, docetaxel, and capecitabine (GTX) regimen for metastatic pancreatic cancer: a retrospective analysis. Cancer Chemother. Pharmacol. 2008;61:167–175. - PubMed
-
- Ychou M, Desseigne F, Guimbaud R, Ducreux M, Bouche O, Becouarn Y, et al. Randomized phase II trial comparing FOLFIRINOX (5FU/leucovorin [LV], irinotecan [I] and oxaliplatin [O]) vs gemcitabine (G) as first-line treatment for metastatic pancreatic adenocarcinoma (MPA). First results of the ACCORD 11 trial. ASCO Meeting Abstr. 2007;25(Suppl. 18):4516.
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