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
74TiP - Phase I study of BI 836880, a VEGF/Ang2-blocking nanobody®, as monotherapy and in combination with BI 754091, an anti-PD-1 antibody, in Japanese patients (pts) with advanced solid tumours
Presenter: Kentaro Yamazaki
Session: Poster display session
Resources:
Abstract
75P - A parallel deep learning network framework for whole-body bone scan image analysis
Presenter: Xiaorong Pu
Session: Poster display session
Resources:
Abstract
76P - Perception and satisfaction of cancer patients in clinical trials
Presenter: Jukyung Jeon
Session: Poster display session
Resources:
Abstract
77P - A prognostic nomogram for the prediction of neuroblastoma
Presenter: Jian-Guo Zhou
Session: Poster display session
Resources:
Abstract
80P - The clinical usefulness of a new fat-dissociation method to detect lymph nodes from surgically resected specimen in colorectal cancer: Prospective randomized study
Presenter: Shiki Fujino
Session: Poster display session
Resources:
Abstract
81P - Concurrent or consolidation chemotherapy during radiation as neoadjuvant treatment for locally advanced rectal cancer: A propensity score analysis from two prospective study
Presenter: JianWei Zhang
Session: Poster display session
Resources:
Abstract
82P - Body mass index, tumour location, and colorectal cancer survival
Presenter: Dake Chu
Session: Poster display session
Resources:
Abstract
83P - Helicobacter bilis may play a role in the carcinogenesis of colitis associated colon cancer correlating to increased number of CD4+CD45RB+ T cells
Presenter: Xiangsheng Fu
Session: Poster display session
Resources:
Abstract
84P - Comprehensive evaluation of relapse risk (CERR) score for colorectal liver metastases development and validation
Presenter: Jianmin Xu
Session: Poster display session
Resources:
Abstract
85P - Which is the best partner for capecitabine-based neoadjuvant chemoradiotherapy in locally advanced rectal cancer? A retrospective analysis of a comprehensive cancer center
Presenter: Jingwen Wang
Session: Poster display session
Resources:
Abstract