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
41P - Clinical verification on the relationship between serum lipid metabolism and the immune microenvironment in breast cancer patients
Presenter: Wataru Goto
Session: Poster display session
Resources:
Abstract
42P - Genome wide copy number analysis of circulating tumour cells in breast cancer liver metastasis
Presenter: Saber Imani
Session: Poster display session
Resources:
Abstract
43P - A hotspot variants p.H1047R and p.H1047L in p110α/ΔNp63α complex affects structure, function and contributes to susceptibility metastatic breast cancer
Presenter: Zou Linglin
Session: Poster display session
Resources:
Abstract
44P - Correlation of circulating tumour cells with PET-CT in metastatic breast cancer
Presenter: Venkata Pradeep Babu Koyyala
Session: Poster display session
Resources:
Abstract
45P - The challenge of evaluating new targeted therapies: Opportunities in stratifying the therapeutic response per tumour location
Presenter: Hubert Beaumont
Session: Poster display session
Resources:
Abstract
46P - Plasma soluble CD36 of breast cancer based on pathological and clinical characteristics
Presenter: Aditia Romadhoni
Session: Poster display session
Resources:
Abstract
47P - Investigation of the use of a novel S-1 administration method for treating metastatic and recurrent breast cancer
Presenter: MAYUKO MIKI
Session: Poster display session
Resources:
Abstract
48P - Development of MDA-MB-231-3D-Spheroid as a reliable model for studying Nav1.5 and nNav1.5-mediated breast cancer metastasis
Presenter: Ahmad Murtadha
Session: Poster display session
Resources:
Abstract
49P - Biochemical study on modifying role of variants of leptin gene and its receptor on serum leptin levels in breast cancer
Presenter: Alshimaa Alhanafy
Session: Poster display session
Resources:
Abstract
50P - Prognostic factors of recurrence or distant metastasis in elderly breast cancer patients
Presenter: Seungju Lee
Session: Poster display session
Resources:
Abstract