Inclusion of the FOLFIRINOX regimen in the treatment algorithm for metastatic pancreatic cancer – first experience
Luboš Petruželka Orcid.org 1, Michal Vočka Orcid.org 1
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Summary
Pancreatic cancer represents ~ 2% of all cancers (6% of all deaths from cancer). The most common histological type (> 90%) are ductal adenocarcinomas. This type of cancer has a strong tendency for local invasion and distant metastases. Therapeutic results in all stages of the disease are worse than in all other solid tumors. Methods: The study involved a total of 23 patients with locally advanced and metastatic pancreatic cancer at the Oncology Clinic of the 1st Faculty of Medicine and General Teaching Hospital in Prague between January 2013 and July 2014. All patients underwent treatment with FOLFIRINOX regimen every two weeks (oxaliplatin 85 mg/m2, irinotecan180 mg/m2, leucovorine 400 mg/m2, bolus of 5-fluorouracile 400 mg/m2 and continual infusion of 5-fluorouracile 2,400 mg/m2 for 46 hours) with a good performance status (PS 0–1) in the first or second line therapy. The antitumor efficacy (number of objective responses, time to progression and overall survival) and adverse events were monitored. Results: The median time to progression was 7.5 months, with one complete remission and six partial remissions according to RECIST. The median number of administered cycles was 10 (from 1 to 17). Irinotecan was reduced in six patients because of toxicity (irinotecan administration had to be discontinued permanently in three patients), oxaliplatin was reduced in five patients (it had to be discontinued permanently in three patients). The median overall survival reached 15.1 months from the diagnosis of inoperable locally advanced or generalized tumor. Conclusion: In patients with advanced pancreatic cancer with a good performance status (0–1) FOLFIRINOX may significantly increase the time to progression and overall survival with a good quality of life.
Keywords
FOLFIRINOX, pancreatic cancer, toxicity, efficiency
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