FOLFIRINOX chemotherapy regimen has been shown to improve overall survival (OS) and progression free survival (PFS) in patients with metastatic pancreatic cancer, however, with an associated increase in toxicity. The primary aim of this multi-centre retrospective analysis was to evaluate toxicity and adverse events and the secondary objective was to assess the efficacy of this regimen in an Australian setting.
A retrospective analysis of patients treated with FOLFIRINOX was conducted at four South Australian tertiary referral hospitals between April 2013 and April 2014. Toxicity was graded as per CTCAE version 4.0. Overall survival and tumour response were analysed.
A total of 30 patients were identified. 63.3% of patients had metastatic disease. The median age was 57 (range 53–63) and the median number of cycles delivered was 5 (range 1-12). ECOG performance status was 1 or 2. 13% patients completed full 12 cycles of FOLFIRINOX. 36.7% of patients received FOLFIRINOX as neoadjuvant treatment with a resection rate of 27%. G3/4 neutropenia occurred in 23.3% patients with febrile neutropenia occurring in 13.3%, diarrhea in 10% and peripheral neuropathy in 10% of patients. The mOS for patients with locally advanced pancreatic cancer was 23.9 months and 12.3 months for patients with metastatic disease with a 1 year SR of 52% in this group.
This multi-centre audit from four tertiary South Australian Hospitals reveal that FOLFIRINOX can be safely delivered in appropriate patient groups outside trial cohort. The toxicity profile and outcome is comparable to other studies using FOLFIRINOX in both LAPC and metastatic disease.
Clinical trial identification
All authors have declared no conflicts of interest.