P-0116 - Standard clinical practice of FOLFIRINOX in Advanced/Metastatic Pancreatic Cancer (PC) Patients: A Canadian Registry

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Presenter Jean Maroun
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors R. Goodwin1, E. Tsvetkova2, H. Marginean3, Y. Ko4, A. Ghafoor5, C. Cripps1, D. Jonker1, R. Goel1, T. Asmis1
  • 1The Ottawa Hospital Cancer Centre, Ottawa/CA
  • 2The Ottawa Hospital Cancer Centre (TOHCC), Ottawa/CA
  • 3The Ottawa Hospital cancer Center, Ottawa/CA
  • 4Sunnybrook Research Institute (SRI), Toronto/CA
  • 5Windsor Regional Hospital, Windsor/CA



Prodige4/ACCORD11 trial demonstrated prolonged survival and maintenance of quality of life in PC. Consequently FOLFIRINOX was implemented in clinical practice as first-line therapy for PC patients with good performance status (PS) and liver function. This Canadian Registry further investigates drug use in clinical care and collects disease outcomes in unselected population.


This ongoing retrospective cohort study is enrolling PC patients who completed at least one cycle of FOLFIRINOX.


125 evaluable patients with unresectable pancreatic adenocarcinoma enrolled between December 2012 and December 2013 in 3 Canadian centers (TOHCC 53%, SRI 38%, WRH 9%); 54% were male; 44% were 65 years or older, median age was 64 years (range 24-80); 60%/29%/11% had PS 0/1/2, location 63% head and 37% body/tail. Patients had metastatic disease 56%, locally advanced disease 26%, local recurrence 18%. Commonest comorbidities were hypertension 40%, diabetes 28%, liver enzyme abnormalities 14% Of the 29 patients who underwent primary surgery, 22 (18%) received adjuvant therapy, of which 19 gemcitabine based. Compared to standard FOLFIRINOX dose, 62% patients started the first cycle with more than one drug dose adjusted due to drug related toxicity to adjuvant chemotherapy or poor PS; 25% patients started the first cycle with all drugs dose reduced; 42% started the regimen with at least 1 drug canceled, 40% with bolus 5FU canceled. Data collected demonstrate differences in regimen management between centers. Data on safety and efficacy will be available at the time of presentation.


In this Canadian registry, patients were older, with inferior PS and more comorbidities compared to those of Prodige4/ACCORD11 trial patients. In routine standard clinical practice management of PC patients differs across centers. Decreased starting doses or omission of bolus 5FU was used frequently in view of expected toxicity, due to patient poor PS and residual toxicity from prior adjuvant treatment.