Abstract 196P
Background
5-FU based regimens represent the gold standard of therapy for gastroesophageal carcinomas. Options include Cisplatin-5FU doublets, FOLFOX and FOLFIRI, and in the neo-adjuvant setting FLOT is emerging as a popular choice for those with good performance status. We identified two cohorts of patients who received m-FOLFIRINOX as first line treatment of gastroesophageal carcinoma; patients undergoing neo-adjuvant therapy in whom FLOT was thought to be too toxic, and those with extensive metastatic disease where it was thought that they would not be fit enough for second line therapy. In these settings there is a theoretical advantage to FOLFIRINOX as it exploits the synergy between Oxaliplatin and Irinotecan; Oxaliplatin forms platinum-DNA adducts and Irinotecan prevents the repair of these adducts impeding the development of platinum resistance. We prospectively evaluated our single institution use of FOLFIRINOX in both neo-adjuvant and advanced treatment of gastro-oesophageal carcinomas.
Methods
14 patients with oesophageal, gastro-oesophageal junction or stomach carcinoma gave informed consent to treatment with FOLFIRINOX. Five of these patients had extensive metastatic disease at diagnosis. Response to treatment was recorded via combined CT/PET scanning, endoscopy reports, tumour markers and pathology.
Results
All nine patients being treated neo-adjuvantly displayed a good metabolic response prior to surgical resection. Of note was one patient who received only two cycles, however achieved reduction in his tumour from T3N2 to T2N0, which was then completely resected. For the five patients with extensive disease, all showed complete metabolic responses on PET, after having an average of 10.6 cycles each of FOLFIRINOX treatment. Only one patient relapsed 6 months after completing treatment, who subsequently responded to FOLFIRINOX retreatment, and died 23 months after diagnosis.
Conclusions
FOLFIRINOX appears to be highly effective in the treatment of early stage and metastatic gastro-oesophageal adenocarcinomas, as well as showing an excellent pathological response rate which aids surgical resection. This case series suggest that the regimen should be formally trialled, comparing tolerability and efficacy against FLOT.
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
154P - Genetic characteristics of participants in the Australian Pancreatic Screening Study
Presenter: Krithika Murali
Session: Poster display session
Resources:
Abstract
155P - Mean Platelet Volume (MPV) is it a new prognostic marker in resectable carcinoma stomach?
Presenter: Girish M. S
Session: Poster display session
Resources:
Abstract
156P - A positive feedback between IDO1 metabolite and COL12A1 via MAPK pathway to promote gastric cancer metastasis
Presenter: Zhen Xiang
Session: Poster display session
Resources:
Abstract
157P - Lymph node ratio (LNR) a better prognostic factor after D2 gastrectomy
Presenter: Jitin Yadav
Session: Poster display session
Resources:
Abstract
158P - A clinical significance of preoperative C-reactive protein/albumin ratio in patients with extrahepatic bile duct cancer
Presenter: Kim Jinkook
Session: Poster display session
Resources:
Abstract
159P - The relation between obesity and cancer of gastrointestinal tract in Korea: The data from Statistic Korea between 2001 and 2016
Presenter: Hee Man Kim
Session: Poster display session
Resources:
Abstract
160P - Clinical outcomes of second-line chemotherapy after progression on nab-paclitaxel plus gemcitabine in patients with metastatic pancreatic adenocarcinoma
Presenter: Jooyoung Ha
Session: Poster display session
Resources:
Abstract
161P - Chitinase 3-Like 1 gene (T/C) polymorphism and serum YKL-40 in hepatocellular carcinoma
Presenter: Alshimaa Alhanafy
Session: Poster display session
Resources:
Abstract
162P - Hypofractionated radiotherapy for pulmonary metastases from hepatocellular carcinoma: Treatment response and prognostic factors affecting survival
Presenter: In Young Jo
Session: Poster display session
Resources:
Abstract
163P - Excision repair cross-complementation group 1 and 2 (ERCC1/2) Single nucleotide polymorphisms and chemotherapy treatment outcome in Cholangiocarcinoma
Presenter: Thanachai Sanlung
Session: Poster display session
Resources:
Abstract