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01-12-2021 | Neutropenia | Review

The role of FOLFIRINOX in metastatic pancreatic cancer: a meta-analysis

Authors: Beilei Zhang, Fengyan Zhou, Jiaze Hong, Derry Minyao Ng, Tong Yang, Xinyu Zhou, Jieyin Jin, Feifei Zhou, Ping Chen, Yunbao Xu

Published in: World Journal of Surgical Oncology | Issue 1/2021

Abstract

Background

The prognosis of pancreatic cancer (PC) is extremely poor, and most patients with metastatic PC still receive palliative care. Here, we report the efficacy and safety of FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, 5-fluorouracil) in the treatment of metastatic PC.

Methods

We searched PubMed, Web of Science, EBSCO, and Cochrane library databases for articles that described efficacy and safety of FOLFIRINOX in patients with metastatic PC, from January 1996 to July 2020. The primary outcomes targeted included overall survival (OS) and progression-free survival (PFS).

Results

We found that FOLFIRINOX could directly improve OS rate of patients with metastatic PC (HR 0.76, 95% Cl 0.67–0.86, p<0.001) but had no benefit on PFS. Results from subgroup analyses showed that FOLFIRINOX had superior benefits than monochemotherapy (HR 0.59, 95% Cl 0.52–0.67, p<0.001), followed by FOLFIRINOX versus combination chemotherapy (HR 0.76, 95% Cl 0.61–0.95, p<0.001). The result of FOLFIRINOX versus nab-paclitaxel + gemcitabine had no benefit (HR 0.91, 95% Cl 0.82–1.02, p>0.05). The main adverse events (AEs) targeted hematological toxicity and the gastrointestinal system, and included febrile neutropenia, a reduction in white blood cells and appetite, as well as diarrhea.

Conclusion

These findings indicated that FOLFIRINOX has potential benefits for the prognosis of patients with metastatic PC. Furthermore, there is no difference between the regimen of FOLFIRINOX and nab-paclitaxel + gemcitabine in this study. The application of FOLFIRINOX should be according to the actual situation of the patients and the experience of the doctors.

Graphical abstract

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Title: The role of FOLFIRINOX in metastatic pancreatic cancer: a meta-analysis
Authors: Beilei Zhang
Fengyan Zhou
Jiaze Hong
Derry Minyao Ng
Tong Yang
Xinyu Zhou
Jieyin Jin
Feifei Zhou
Ping Chen
Yunbao Xu
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Neutropenia
Pancreatic Cancer
Pancreatic Cancer
Cytostatic Therapy
Published in: World Journal of Surgical Oncology / Issue 1/2021
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-021-02291-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The role of FOLFIRINOX in metastatic pancreatic cancer: a meta-analysis

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

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