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A retrospective study of neoadjuvant FOLFIRINOX in unresectable or borderline-resectable locally advanced pancreatic adenocarcinoma

Hosein, Peter J ; Macintyre, Jessica ; Kawamura, Carolina ; Maldonado, Jennifer Cudris ; Ernani, Vinicius ; Loaiza-Bonilla, Arturo ; Narayanan, Govindarajan ; Ribeiro, Afonso ; Portelance, Lorraine ; Merchan, Jaime R ; Levi, Joe U ; Rocha-Lima, Caio M

BMC cancer, 2012-05, Vol.12 (1), p.199-199, Article 199 [Periódico revisado por pares]

England: BioMed Central Ltd

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Título:
A retrospective study of neoadjuvant FOLFIRINOX in unresectable or borderline-resectable locally advanced pancreatic adenocarcinoma
Autor: Hosein, Peter J ; Macintyre, Jessica ; Kawamura, Carolina ; Maldonado, Jennifer Cudris ; Ernani, Vinicius ; Loaiza-Bonilla, Arturo ; Narayanan, Govindarajan ; Ribeiro, Afonso ; Portelance, Lorraine ; Merchan, Jaime R ; Levi, Joe U ; Rocha-Lima, Caio M
Assuntos: Adjuvant treatment ; Adult ; Aged ; Algorithms ; Antimitotic agents ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Camptothecin - adverse effects ; Camptothecin - analogs & derivatives ; Camptothecin - therapeutic use ; Cancer ; Cancer therapies ; Care and treatment ; Chemotherapy ; Colleges & universities ; Development and progression ; Diarrhea ; Female ; Fluorouracil - adverse effects ; Fluorouracil - therapeutic use ; Health aspects ; Hospitals ; Humans ; Leucovorin ; Leucovorin - adverse effects ; Leucovorin - therapeutic use ; Male ; Medicine ; Metastasis ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Oncology ; Organoplatinum Compounds - adverse effects ; Organoplatinum Compounds - therapeutic use ; Pancreatic cancer ; Pancreatic ductal carcinoma ; Pancreatic Neoplasms - drug therapy ; Pancreatic Neoplasms - mortality ; Pancreatic Neoplasms - pathology ; radiation therapy ; Radiotherapy ; Retrospective Studies ; Surgery ; Treatment Outcome
É parte de: BMC cancer, 2012-05, Vol.12 (1), p.199-199, Article 199
Descrição: 5-fluorouracil, leucovorin, irinotecan and oxaliplatin (FOLFIRINOX) is superior to gemcitabine in patients with metastatic pancreatic cancer who have a good performance status. We investigated this combination as neoadjuvant therapy for locally advanced pancreatic cancer (LAPC). In this retrospective series, we included patients with unresectable LAPC who received neoadjuvant FOLFIRINOX with growth factor support. The primary analysis endpoint was R0 resection rate. Eighteen treatment-naïve patients with unresectable or borderline resectable LAPC were treated with neoadjuvant FOLFIRINOX. The median age was 57.5 years and all had ECOG PS of 0 or 1. Eleven (61 %) had tumors in the head of the pancreas and 9 (50 %) had biliary stents placed prior to chemotherapy. A total of 146 cycles were administered with a median of 8 cycles (range 3-17) per patient. At maximum response or tolerability, 7 (39 %) were converted to resectability by radiological criteria; 5 had R0 resections, 1 had an R1 resection, and 1 had unresectable disease. Among the 11 patients who remained unresectable after FOLFIRINOX, 3 went on to have R0 resections after combined chemoradiotherapy, giving an overall R0 resection rate of 44 % (95 % CI 22-69 %). After a median follow-up of 13.4 months, the 1-year progression-free survival was 83 % (95 % CI 59-96 %) and the 1-year overall survival was 100 % (95 % CI 85-100 %). Grade 3/4 chemotherapy-related toxicities were neutropenia (22 %), neutropenic fever (17 %), thrombocytopenia (11 %), fatigue (11 %), and diarrhea (11 %). Common grade 1/2 toxicities were neutropenia (33 %), anemia (72 %), thrombocytopenia (44 %), fatigue (78 %), nausea (50 %), diarrhea (33 %) and neuropathy (33 %). FOLFIRINOX followed by chemoradiotherapy is feasible as neoadjuvant therapy in patients with unresectable LAPC. The R0 resection rate of 44 % in this population is promising. Further studies are warranted.
Editor: England: BioMed Central Ltd
Idioma: Inglês

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A retrospective study of neoadjuvant FOLFIRINOX in unresectable or borderline-resectable locally advanced pancreatic adenocarcinoma

Hosein, Peter J ; Macintyre, Jessica ; Kawamura, Carolina ; Maldonado, Jennifer Cudris ; Ernani, Vinicius ; Loaiza-Bonilla, Arturo ; Narayanan, Govindarajan ; Ribeiro, Afonso ; Portelance, Lorraine ; Merchan, Jaime R ; Levi, Joe U ; Rocha-Lima, Caio M

England: BioMed Central Ltd

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