Neo-adjuvant FOLFIRINOX in borderline resectable and locally advanced pancreatic adenocarcinoma.

Autor: Temraz S; Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon., Nassar F; Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon., Hammoud MS; Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon., Mukherji D; Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon., O'Reilly EM; Memorial Sloan-Kettering Cancer Center, New York, New York, USA., Dbouk H; Department of Internal Medicine, Hematology/Oncology Division, Nabih Berri Governmental University Hospital, Nabatieh, Lebanon., Farhat F; Department of Internal Medicine, Hematology/Oncology Division, Hammoud Hospital University Medical Center, Saida, Lebanon., Charafeddine M; Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon., Faraj W; Department of Surgery, General surgery Division, American University of Beirut Medical Center, Beirut, Lebanon., Khalifeh MJ; Department of Surgery, General surgery Division, American University of Beirut Medical Center, Beirut, Lebanon., Abou-Alfa GK; Memorial Sloan-Kettering Cancer Center, New York, New York, USA., Shamseddine A; Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon.
Jazyk: angličtina
Zdroj: Asia-Pacific journal of clinical oncology [Asia Pac J Clin Oncol] 2022 Dec; Vol. 18 (6), pp. 735-742. Date of Electronic Publication: 2022 Mar 31.
DOI: 10.1111/ajco.13775
Abstrakt: Background: Surgery and systemic therapy provide the best option for long-term cancer control in localized resectable pancreas cancer. The present study assessed the efficacy and safety of neoadjuvant treatment with FOLFIRINOX in patients with borderline resectable (BR) and locally advanced (LA) pancreas cancer (PDAC).
Methods: This was a prospective noninterventional observational trial of neoadjuvant FOLFIRINOX in BR and LA PDAC. The primary objective was the R0/R1 surgical resection rate. Secondary objectives included progression free survival (PFS) and overall survival (OS), tolerability, and toxicity.
Results: Forty-nine patients were enrolled between 2013 and 2019; the majority had LA disease (59.2%). Median age was 61 years, and median Ca 19-9 level pretreatment was 523.4 μmol/L. Following neoadjuvant FOLFIRINOX, 11 patients (22.5%) underwent surgical resection, the majority of which were BR at diagnosis (72.7%). Median OS and PFS for the entire group were 25 (95% CI: 17.2-32.8) and 12 months (95% CI: 9.7-13.3), respectively. Median PFS in BR patients was 14 (95% CI: 10.5-17.5) compared to 12 months (95% CI: 5.2-18.8) in patients with LA patients. Median OS and PFS were not reached in patients who underwent surgical resection as compared to 22 (95% CI: 18.6-25.4) and 9 months (95% CI: 4.2-13.9) in those who did not, respectively. Grade 3/4 neutropenia, leukopenia, neuropathy, nausea/vomiting, and diarrhea occurred in 6.3%, 2.1%, 10.4%, 4.2%, and 8.3%, respectively.
Conclusion: Neoadjuvant FOLFIRINOX is an active regimen for patients with LA/BR PDAC with a resection rate of 22.5%. These results are in line with prior data.
(© 2022 John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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