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
437P - Correlation between bio-impedance analysis and abdominal CT scan to diagnose decreased muscle mass in adult cancer patients
Presenter: Andree Kurniawan
Session: Poster display session
Resources:
Abstract
438P - Evaluating mitochondrial biomarkers between fatigue subclasses identified using latent class analysis in early-stage breast cancer patients
Presenter: Yi Long Toh
Session: Poster display session
Resources:
Abstract
440P - Accuracy of risk scoring system to determine delayed chemotherapy induced nausea and vomiting (CINV) in cancer patients
Presenter: Jada Harika
Session: Poster display session
Resources:
Abstract
441P - A pilot cross-sectional study on incidence of liver toxicity in cancer patients on western anti-cancer drug therapy with or without concurrent Chinese herbal medicine
Presenter: Tsz Him So
Session: Poster display session
Resources:
Abstract
442P - Relationship between QOL and support elderly patients with permanent colostomies
Presenter: Yukiko Orii
Session: Poster display session
Resources:
Abstract
443P - The effectiveness of individual nutritional counselling for patients with advanced cancer undergoing chemotherapy: A preliminary study
Presenter: Saori Koshimoto
Session: Poster display session
Resources:
Abstract
444P - The prophylactic effect of 0.1% fluorometholone eye drops on eye disorders caused by high-dose cytarabine
Presenter: Takayuki Tsuchiya
Session: Poster display session
Resources:
Abstract
445P - Safety and feasibility of extending flushing interval every 3 months for maintenance of TICVPS in CRC patients after completion of curative intended treatments
Presenter: Sang Bo Oh
Session: Poster display session
Resources:
Abstract
446P - Accuracy of risk scoring system to determine chemotherapy induced nausea and vomiting (CINV) in cancer patients receiving first cycle chemotherapy
Presenter: Jada Harika
Session: Poster display session
Resources:
Abstract
447P - Hypomagnesaemia: An unnoticed problem in lung cancer patients treated with concurrent chemoradiation
Presenter: Sharif Ahmed
Session: Poster display session
Resources:
Abstract