703P - Who should receive first-line FOLFIRINOX? Prognostic factors in locally advanced or metastatic pancreatic cancer patients

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Pancreatic Cancer
Biological Therapy
Presenter Kalliopi Andrikou
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors K. Andrikou1, A. Bittoni2, A. Lanese2, M. Santoni1, C. Pellei1, A. Conti1, F. Aroldi3, A. Brunetti4, M. Russano5, V. Vaccaro6, N. Silvestris4, M. Milella7, D. Santini8, A. Zaniboni9, S. Cascinu1
  • 1Medical Oncology, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT
  • 2Clinica Di Oncologia Medica, Ospedali Riuniti di Ancona, 60019 - Ancona/IT
  • 3Medical Oncology, Fondazione Poliambulanza, brescia/IT
  • 4Medical Oncology Unit, National Cancer Institute "Giovanni Paolo II", 70124 - bari/IT
  • 5Medical Oncology, University Campus Bio-Medico, rome/IT
  • 6Medical Oncology, Regina Elena National Cancer Institute, 00144 - Roma/IT
  • 7Division Of Medical Oncology A, Regina Elena National Cancer Institute, Rome/IT
  • 8Medical Oncology, Campus Bio-Medico di Roma, 00128 - Roma/IT
  • 9Oncology Department, Fondazione Poliambulanza, IT-25124 - Brescia/IT



FOLFIRINOX represents an active regimen in first-line treatment of advanced pancreatic adenocarcinoma (PDAC) patients (pts) with good performance status (PS). Aim of this study was to evaluate the presence of existing prognostic criteria in this population.


We retrospectively investigated clinical and laboratory characteristics of pts treated with first-line FOLFIRINOX regimen for locally advanced or metastatic PDAC between June 2011 and April 2014 in four Italian institutions. Survival estimates were quantified using Kaplan Meier curves. Age, tumor stage, presence of biliary stents, ECOG-Performance Status (PS) and pre-treatment CEA, CA 19-9, LDH, hemoglobin, neutrophil, lymphocyte and platelet counts as well as body mass index (BMI) were included in the Cox analysis to investigate their prognostic relevance.


96 pts treated with FOLFIRINOX as first-line chemotherapy were analyzed. Median age was 61 years (range 36-76); 63 pts were males (66%). PDAC was locally advanced in 46 (48%) and metastatic in 50 pts (52%). Median progression-free survival (PFS) was 4.9 months and median overall survival (OS) was 10.6 months. At multivariate analysis, only ECOG-PS ≥ 2 (p = 0.02) was significantly associated with poor OS. Furthermore, ECOG-PS ≥ 2 (p = 0.040), neutrophilia (p = 0.007) and the presence of biliary stent (p = 0.017) were independent prognostic factor for worst PFS.


Pre-treatment neutrophilia, ECOG-PS ≥ 2 and the presence of biliary stent were independent prognostic factor for patients treated with first-line FOLFIRINOX, suggesting that the use of this regimen in patients with these features should be carefully considered.


All authors have declared no conflicts of interest.