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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

3468 - FOLFIRINOX for recurrent pancreatic cancer after resection: nationwide multicenter observational study by Japan Adjuvant Study Group of Pancreatic Cancer (JASPAC)

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Cytotoxic Therapy

Tumour Site

Pancreatic Cancer

Presenters

Soichiro Morinaga

Citation

Annals of Oncology (2018) 29 (suppl_8): viii205-viii270. 10.1093/annonc/mdy282

Authors

S. Morinaga1, M. Takita2, A. Yoshizawa3, K. Kamei4, S. Nakamori5, S. Ishihara6, H. Kuramochi7, Y. Yokoyama8, T. Uchiyama9, G. Murohisa10, M. Kobayashi11, A. Todaka12, A. Fukutomi13

Author affiliations

  • 1 Department Of Gastrointestinal Surgery, Kanagawa Cancer Center, 2410815 - Yokohama/JP
  • 2 Department Of Clinical Study, Kanagawa Cancer Center, 2410815 - Yokohama/JP
  • 3 Department Of Biostatistics, Kanagawa Prefectural Hospital Organization, 2410815 - Yokohama/JP
  • 4 Department Of Surgery, Kinki University Faculty of Medicine, Osakasakai/JP
  • 5 Department Of Hepatobiliary And Pancreatic Surgery, National Hospital Organization Osaka National Hospital, 540-0006 - Osaka/JP
  • 6 Department Of Surgery, Fujita Health University, Toyoake/JP
  • 7 Department Of Chemotherapy, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo/JP
  • 8 Department Of Gastrointestinal Surgery, Nagoya University Hospital, Nagoya/JP
  • 9 Department Of Surgery, Kikugawa General Hospital, Kikugawa/JP
  • 10 Department Of Gastrointestinal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu/JP
  • 11 Clinical Trial Promotion Section, Pharma Valley Center, Shizuoka/JP
  • 12 Division Of Gastrointestinal Oncology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 13 Gastrointestinal Oncology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
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Resources

Abstract 3468

Background

There are concerns about more severe toxicities of FOLFIRINOX use in case with recurrent disease after pancreatic resection, because a certain number of these patients suffer from malnutrition, weight loss, and diabetes mellitus induced by pancreatic exocrine or endocrine insufficiency. Today, FOFIRINOX is widely adopted also in recurrent disease after resection beside metastatic disease studied in the ACCORD trial, yet can be associated with significant severe toxicity. We aimed to clarify toxicity and tolerance of FOLFIRNOX use in patients with recurrent disease after resection.

Methods

This study was carried out as an incidental research of JASPAC 06 study which examined multi-institutional experience with FOLFIRINOX use in pancreatic cancer by registration study. We focused on toxicity and tolerance of FOLFIRINOX use in case with recurrent disease after resection, and correlated them with those of locally advanced or metastatic disease group.

Results

From Nov. 2014 to May. 2015, 399 patients were registered in JASPAC 06, 80 patients (20%) had recurrent disease, 78 (20%) had locally advanced disease, and 241 (60%) had metastatic disease. There were no difference in background such as age, sex, ECOG PS, pathology and CA19-9 level between recurrent disease group and locally advanced or metastatic disease group. FOLFIRINOX was initiated as modified manner in 69% of recurrent group and 67% of locally advanced or metastatic group. The major grade 3-4 toxicities observed in recurrent group and locally advanced or metastatic disease group were neutropenia (68% vs 63%), febrile neutropenia (4% vs 15%, p = 0.007), thrombocytopenia (4% vs 3%), anemia (8% vs 10%), fatigue (4% vs 3%), anorexia (14% vs 14%). The median treatment duration and median treatment cycle in recurrence group and locally advanced or metastatic group was 2.9 months vs 4.1 months, and 4cycle vs 6cycle. There was no difference in relative dose intensity between two groups.

Conclusions

Toxicity and tolerance of FOLFIRINOX use in recurrent disease after pancreatic resection were similar to those of use in locally advanced or metastatic disease.

Clinical trial identification

Legal entity responsible for the study

Japan Adjuvant Study Group of Pancreatic Cancer.

Funding

Yakult Honsha Co., Ltd., Daiichi Sankyo Co., Ltd. and Pharma Valley Center.

Editorial Acknowledgement

Disclosure

S. Nakamori: Eisai Co. Ltd. A. Todaka: Honoraria: Yakult Honsha Co., Ltd, Daiichi Sankyo Co., Ltd. A. Fukutomi: Honoraria: Yakult Honsha Co., Ltd, Daiichi Sankyo Co., Ltd; Advisory role: Yakult Honsha Co., Ltd. All other authors have declared no conflicts of interest.

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