Abstract 182P
Background
The efficacy of FOLFIRINOX in the treatment of pancreatic adenocarcinoma is well known and documented. However, most published data involves young patients with a performance status ≤1 (ACCORD study). Thus, traditionally FOLFIRINOX has been regarded as a first line only treatment for patients with good performance status. Patients requiring second line therapy are not regarded as being fit enough to receive FOLFIRINOX. We have previously published our experience that m-FOLFIRINOX can be utilised safely in these individuals, with appropriate dose reductions. Our position has been supported by a subsequent systematic review (Tong et al.). This updated report of our dual institution experience adds further evidence supporting the use of m-FOLFIRINOX as a second line treatment for pancreatic adenocarcinoma.
Methods
A retrospective analysis was conducted on patients with locally advanced or metastatic pancreatic adenocarcinoma from two institutions who received first-line gemcitabine plus nab-paclitaxel, followed by second-line m-FOLFIRINOX between December 2011 and July 2019. All patients had an ECOG performance status of 2 or less. Overall survival (OS) was estimated via the Kaplan-Meier method.
Results
We identified 85 patients in our analysis, with 64% patients having metastatic disease at diagnosis. The median age of our patients at diagnosis was 65 (range, 26 – 81). The dose intensity of m-FOLFIRINOX was the following: 65% for oxaliplatin, 68% for irinotecan, 18% for bolus 5-fluorouracil (5-FU) and 68% for infusional 5-FU. The median OS of all patients was 46.0 months (95% CI, 35.0 – 68.0). The median OS of locally advanced and metastatic pancreatic cancer from diagnosis was 68.0 months (95% CI, 45.0 – 68.0) and 23.0 months (95% CI, 19.0 – 49.0), respectively.
Conclusions
Our expanded case series continues to demonstrate the growing role of m-FOLFIRINOX as a second line therapy for advanced metastatic pancreatic cancer, after the failure of first-line gemcitabine plus nab-paclitaxel. We continue to suggest that formal clinical trials are needed to further investigate this efficacy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
St John of God Hospital, Subiaco.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
133P - Prognostic and predictive factors from the phase III CELESTIAL trial of cabozantinib (C) versus placebo (P) in previously treated advanced hepatocellular carcinoma (aHCC)
Presenter: Thomas Yau
Session: Poster display session
Resources:
Abstract
134P - Identification, development and validation of a circulating miRNA-based diagnostic signature for early detection of gastric cancer
Presenter: Daisuke Izumi
Session: Poster display session
Resources:
Abstract
135P - The promising key genes associated with tumour microenvironment and prognosis of hepatocellular carcinoma
Presenter: Jing Fang
Session: Poster display session
Resources:
Abstract
136P - Helicobacter pylori-positive gastric diffuse large B-cell lymphoma: A subset with distinct prognostic features
Presenter: Yuan Cheng
Session: Poster display session
Resources:
Abstract
137P - Significant benefit of pyrotinib combined with SHR6390 in patients with multiline-resistant HER2-positive advanced gastric cancer
Presenter: Zuhua Chen
Session: Poster display session
Resources:
Abstract
138P - Incidence of supracarinal lymph node positivity in operated cases of total esophagectomy: Short term results from a tertiary cancer centre
Presenter: Akhil Palod
Session: Poster display session
Resources:
Abstract
139P - Prognostic usefulness of advanced lung cancer inflammation index in locally-advanced pancreatic carcinoma patients treated with radical chemoradiotherapy
Presenter: Ayberk Besen
Session: Poster display session
Resources:
Abstract
140P - Pancreaticoduodenectomy versus combined neoadjuvant chemotherapy and pancreaticoduodenectomy: Survival patterns among patients with stage II & III periampullary carcinoma
Presenter: Mai Abdelkader
Session: Poster display session
Resources:
Abstract
141P - A 13-gene signature of DNA repair predicts prognosis in gastric cancer patients
Presenter: Jinjia Chang
Session: Poster display session
Resources:
Abstract
142P - Relation between Interleukin -4 (590C/T) gene polymorphism and hepatocellular carcinoma risk in HBV and HCV patients
Presenter: Suzy Gohar
Session: Poster display session
Resources:
Abstract