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Poster Display session 2

1668 - FOLFIRINOX in locally advanced (LA) and borderline resectable (BR) pancreatic adenocarcinoma : update of the AGEO cohort.

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Pancreatic Adenocarcinoma

Presenters

Edouard Auclin

Citation

Annals of Oncology (2019) 30 (suppl_5): v253-v324. 10.1093/annonc/mdz247

Authors

E. Auclin1, L. Marthey2, L. Mas3, E. Francois4, A. Sa Cunha5, J. Bachet6, D. Tougeron7, A. Vienot8, T. Lecomte9, V. Hautefeuille10, J. Forestier11, M. Collins2, R. Abdallah2, R. Coriat12, A. Pointet13, F. Leroy14, F. Ksontini3, N. Williet15, J. Taieb16

Author affiliations

  • 1 Gastrointestinal And Medical Oncology, Hopital European George Pompidou, 75015 - Paris/FR
  • 2 Gastroenterology, CHU de Bicêtre, 91275 - Le Kremlin Bicetre/FR
  • 3 Gastroenterology, APHP Hôpital Pitié Salpêtrière, 75013 - Paris/FR
  • 4 Oncology, Centre Anticancer Antoine Lacassagne, 6100 - Nice/FR
  • 5 Centre Hepetobiliaire, Universite Paris Sud, 91400 - Orsay/FR
  • 6 Gastroenterology, Groupe Hospitalier Pitié Salpetriere, 75013 - Paris/FR
  • 7 Gastroenterology And Oncology, CHU Poitiers, Jean Bernard Hôpital, 86021 - Poitiers/FR
  • 8 25, CHRU Besancon - Hopital Jean Minjoz, 25030 - Besançon/FR
  • 9 Hepato-gastroenterology And Digestive Oncology, CHU de Tours, Hôpital Trousseau, 37170 - Chambray-lès-Tours/FR
  • 10 Gastroenterology And Digestive Oncology, CHU Amiens-Picardie Site Nord, 80054 - Amiens/FR
  • 11 Gastroenterology, Hopital Edouard Herriot Pav. E bis, 69437 - Lyon/FR
  • 12 Gastroenterology, Hôpital Cochin, 75014 - Paris/FR
  • 13 Gastrointestinal Oncology, Hopital European George Pompidou, 75015 - Paris/FR
  • 14 Medical Oncology, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 15 Gastroenterology, University Hospital of Saint-Etienne, 42270 - Saint Priest en Jarez/FR
  • 16 Department Of Gastroenterology And Digestive Oncology, Hopital European George Pompidou, 75015 - Paris/FR

Resources

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Abstract 1668

Background

FOLFIRINOX has shown promising results in LA or BR pancreatic adenocarcinoma (PA) in non-randomized series. We report here an updated large cohort of pts treated with FOLFIRINOX for a LA or BR PA.

Methods

This French retro-prospective multicenter study included all consecutive patients (pts), PS 0/1/2, with non-metastatic, non-resectable, non-pretreated, LA or BR PA treated with FOLFIRINOX. Non-resectability was defined by each center’s multidisciplinary team meeting at diagnosis according to the ISGPS guidelines. FOLFIRINOX chemotherapy (CT) was performed as described in the PRODIGE 4 trial until progression, major toxicity or consolidation treatment radiotherapy (RT) or surgery.

Results

At the time of database lock, in December 2018, 293 pts were included (42% female, 33% > 65 years, 97% PS < 2). Disease was classified as BR (32%) or LA (68%). After a median of 7 (IQR: 5-11) CT cycles, objective response rate was 29% and stable disease 51%. Subsequent RT was performed in 42% and 24% had a curative intent surgery (R0: 72%; ypT0N0: 9%). Resection rates were 40% for BR and 17% for LA pts. Main G3/4 toxicities were: fatigue (14%), neutropenia (12%), nausea (8%) and diarrhea (7%). Oxaliplatin-induced peripheral neuropathy G2/3 was observed in 34%. 13% of pts has stopped chemotherapy for toxicity including 2 toxic deaths. After consolidation RT and/or surgery disease progression occurred in 52% and was mainly metastatic (56%). After a median follow-up of 24 months (mo), median OS (mOS) and PFS were 21 and 12 mo, respectively. mOS was 27 mo for BR and 19 mo for LA pts (p=.002). For pts treated by CT alone, or CT+RT, or CT+/-RT+surgery mOS were 14 mo, 22 mo and not reached, respectively (p<.0001). A trend to a better survival was seen when RT was performed before surgery (mOS 29 mo vs not reached, p=.08).

Conclusions

FOLFIRINOX for LA and BR PA seems to be effective with a manageable toxicity profile. However secondary surgery rate and OS were lower than what we previously reported, but similar to the meta-analysis we previously published. These promising results in “real life” pts have now to be confirmed in phase III randomized trial (PRODIGE 29 - NEOPAN). Updated results will be presented at the meeting.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

AGEO.

Funding

Has not received any funding.

Disclosure

E. Francois: Advisory / Consultancy: Roche; Advisory / Consultancy: Servier; Advisory / Consultancy: Amgen; Advisory / Consultancy: MSD; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Novartis. J. Bachet: Advisory / Consultancy, Travel / Accommodation / Expenses: Amgen; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Bayer; Advisory / Consultancy, Travel / Accommodation / Expenses: Merck Serono; Advisory / Consultancy: Pierre Fabre; Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Advisory / Consultancy, Travel / Accommodation / Expenses: Servier; Advisory / Consultancy, Travel / Accommodation / Expenses: Sanofi. D. Tougeron: Advisory / Consultancy: Amgen; Advisory / Consultancy: Merck; Advisory / Consultancy: Novartis; Advisory / Consultancy: BMS; Advisory / Consultancy: MSD; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Roche; Advisory / Consultancy: Bayer; Advisory / Consultancy: Servier. J. Forestier: Honoraria (self): Amgen; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Bayer; Honoraria (self), Speaker Bureau / Expert testimony, Research grant / Funding (self): Ipsen; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Sanofi; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Merck; Honoraria (self): Servier. R. Coriat: Advisory / Consultancy: Novartis; Advisory / Consultancy: Amgen; Advisory / Consultancy: Roche; Advisory / Consultancy: Merck; Advisory / Consultancy: Ipsen; Advisory / Consultancy: Bayer; Advisory / Consultancy: Keocyt. J. Taieb: Advisory / Consultancy: Amgen; Advisory / Consultancy: Lily; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Roche; Advisory / Consultancy: Merck; Advisory / Consultancy: MSD; Advisory / Consultancy: Celgene; Advisory / Consultancy: Servier; Advisory / Consultancy: Sirtex; Advisory / Consultancy: Pierre Fabre; Advisory / Consultancy: Amgen; Advisory / Consultancy: Amgen. All other authors have declared no conflicts of interest.

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