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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2015

01-10-2015 | Pancreatic Tumors

FOLFIRINOX Induction Therapy for Stage 3 Pancreatic Adenocarcinoma

Authors: Eran Sadot, MD, Alexandre Doussot, MD, Eileen M. O’Reilly, MD, Maeve A. Lowery, MD, Karyn A. Goodman, MD, Richard Kinh Gian Do, MD, PhD, Laura H. Tang, MD, PhD, Mithat Gönen, PhD, Michael I. D’Angelica, MD, Ronald P. DeMatteo, MD, T. Peter Kingham, MD, William R. Jarnagin, MD, Peter J. Allen, MD

Published in: Annals of Surgical Oncology | Issue 11/2015

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Abstract

Background

Reports show that FOLFIRINOX therapy for pancreatic ductal adenocarcinoma (PDAC) results in objective response rates two to threefold higher than those of other regimens. This study aimed to assess response and resection rates for locally unresectable (stage 3) patients initially treated with induction FOLFIRINOX.

Methods

The institutional cancer database was queried for patients treated with induction FOLFIRINOX therapy between 2010 and 2013. Patients were included in the study if they were treated at the authors’ institution for stage 3 PDAC (locally unresectable) that had been adjudicated at a weekly multidisciplinary tumor board.

Results

The study identified 101 patients. The median age was 64 years (range 37–81 years), and the median follow-up period was 12 months (range 3–37 months). The patients received a median of six cycles (range 1–20 cycles) of induction FOLFIRINOX. No grade 4 or 5 toxicity was recorded. At the initial restaging (median of 3 months after diagnosis), 23 patients (23 %) had developed distant metastases, 15 patients (15 %) had undergone resection, and 63 patients (63 %) had proceeded to chemoradiation. In the group of 63 patients who had proceeded to chemoradiation (median of 9 months after diagnosis), an additional 16 patients (16 %) had undergone resection, and 5 patients (5 %) had developed metastases. A partial radiographic response was observed in 29 % of all the patients, which was associated with ability to perform resection (p = 0.004). The median overall survival time was 11 months for the group that progressed with FOLFIRINOX and 26 months for the group that did not progress.

Conclusion

Nearly one third of the patients who had been initially identified as having stage 3 pancreatic carcinoma and had been treated with FOLFIRINOX responded radiographically and underwent tumor resection.
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Metadata
Title
FOLFIRINOX Induction Therapy for Stage 3 Pancreatic Adenocarcinoma
Authors
Eran Sadot, MD
Alexandre Doussot, MD
Eileen M. O’Reilly, MD
Maeve A. Lowery, MD
Karyn A. Goodman, MD
Richard Kinh Gian Do, MD, PhD
Laura H. Tang, MD, PhD
Mithat Gönen, PhD
Michael I. D’Angelica, MD
Ronald P. DeMatteo, MD
T. Peter Kingham, MD
William R. Jarnagin, MD
Peter J. Allen, MD
Publication date
01-10-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 11/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4647-4

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