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
381P - XKR8 is a promising potential prognostic marker in glioblastoma multiforme patients
Presenter: Kristina Havrysh
Session: Poster display session
Resources:
Abstract
383P - Screening of prognostic molecular biomarker for resectable pancreatic cancer
Presenter: Yonggang Peng
Session: Poster display session
Resources:
Abstract
384P - Prevalence of abnormal microsatellite instability test among ovary and endometrial cancer patients
Presenter: Min Kyu Kim
Session: Poster display session
Resources:
Abstract
385P - Identifying CASP8 polymorphisms associated with breast cancer risk in an Iranian population
Presenter: Alireza Pasdar
Session: Poster display session
Resources:
Abstract
386P - Unusual folding of NaPi2b transporter extramembrane domain 4 during malignant transformation
Presenter: Leysan Minigulova
Session: Poster display session
Resources:
Abstract
387P - 5-years conditional disease free survival and overall survival for breast cancer patients in South Korea
Presenter: Jee hyun Ahn
Session: Poster display session
Resources:
Abstract
388P - To identify circulating tumour cells by machine learning approach
Presenter: Yuebin Liang
Session: Poster display session
Resources:
Abstract
389P - The establishment of patient-derived organoid models and drug response of resectable non-small cell lung cancer
Presenter: Jing-Hua Chen
Session: Poster display session
Resources:
Abstract
395P - Filipinos and lung cancer: An infodemiological assessment using Google trends from 2009 to 2019
Presenter: Lance Isidore Catedral
Session: Poster display session
Resources:
Abstract
396P - Determinants of visiting a referral hospital for cervical cancer screening at Uganda Cancer Institute
Presenter: Collins Mpamani
Session: Poster display session
Resources:
Abstract