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. 2017 Jul 11;8(28):46337-46347.
doi: 10.18632/oncotarget.17940.

Efficacy and safety of neoadjuvant FOLFIRINOX for borderline resectable pancreatic adenocarcinoma: improved efficacy compared with gemcitabine-based regimen

Changhoon Yoo  1 , Jihoon Kang  1 , Kyu-Pyo Kim  1 , Jae-Lyun Lee  1 , Baek-Yeol Ryoo  1 , Heung-Moon Chang  1 , Sang Soo Lee  2 , Do Hyun Park  2 , Tae Jun Song  2 , Dong Wan Seo  2 , Sung Koo Lee  2 , Myung-Hwan Kim  2 , Jin-Hong Park  3 , Dae Wook Hwang  4 , Ki Byung Song  4 , Jae Hoon Lee  4 , Song Cheol Kim  4
Affiliations

Efficacy and safety of neoadjuvant FOLFIRINOX for borderline resectable pancreatic adenocarcinoma: improved efficacy compared with gemcitabine-based regimen

Changhoon Yoo et al. Oncotarget. .

Abstract

Borderline resectable pancreatic cancer (BRPC) is a potentially resectable disease but is associated with poorer survival compared to primary resectable disease. There has been no prospective trial that compare the efficacy of FOLFIRNOX and gemcitabine-based regimen for BRPC. Between February 2013 and December 2014, 18 patients with BRPC receiving FOLFIRINOX were reviewed retrospectively. For comparative analysis, data for all BRPC patients (n=18) in our previous phase 2 study of neoadjuvant fixed-dose rate-gemcitabine plus capecitabine were pooled. Patients received a median 6 cycles (range, 3-13) of FOLFIRINOX. Surgical resection was performed in 12 patients (67%) and R0 resection in 9 patients. Median progression-free survival (PFS) and overall survival (OS) were 16.8 (95% confidence interval [CI], 9.4-24.2) and 21.2 (95% CI, 14.2-28.2) months, respectively. Patients who underwent surgical resection showed significantly better PFS (p=0.01) and OS (p=0.003) than those unresected. In the exploratory analysis, patients receiving FOLFIRINOX showed significantly longer PFS compared to those receiving fixed-dose rate-gemcitabine plus capecitabine (median 16.8 months [95% CI, 9.4-24.2] vs. 6.5 months [1.6-11.3]; p = 0.04). There was a trend toward improved OS in patients who received FOLFIRINOX (median 21.2 months [95% CI, 14.2-28.2]) compared to those who received fixed-dose rate-gemcitabine plus capecitabine (13.6 months [11.8-15.4]; p=0.12). FOLFIRINOX was feasible and effective as neoadjuvant chemotherapy for patients with BRPC and may have improved efficacy compared to a gemcitabine-based regimen.

Keywords: FOLFIRINOX; chemotherapy; neoadjuvant; pancreatic cancer.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1. Survival outcomes with FOLFIRINOX
Figure 2
Figure 2
Progression-free survival (A) and overall survival (B) according to surgical resection.
Figure 3
Figure 3
Progression-free survival (A) and overall survival (B) according to chemotherapy regimen (FOLFIRINOX vs. FDR-GEM plus CAP).
See this image and copyright information in PMC

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