Clinical outcomes of FOLFIRINOX in locally advanced pancreatic cancer: A single center experience.

Abstract

480 Background: Approximately, one third of pancreatic cancer patients have locally advanced status at diagnosis. Systemic chemotherapy or chemoradiotherapy is the main option for patients with locally advanced pancreatic cancer (LAPC). Recently, many studies have been investigating the efficacy of FOLFIRINOX (5-fluorouracil [5-FU], oxaliplatin, irinotecan and leucovorin) in LAPC patients. The aim of this study is to assess the clinical outcomes of FOLFIRINOX in patients with LAPC. Methods: Patients with LAPC who received FOLFIRINOX as an initial chemotherapy were identified via the Seoul National University Bundang Hospital database warehouse retrospectively. Demographic characteristics, disease status, chemotherapy duration and cumulative relative dose intensity (cRDI), conversion to resection and clinical outcomes were reviewed. Resectabilitywas determined based on National Cancer Comprehensive Network (NCCN) guidelines version 1.2016. Results: Fifty-one LAPC patients between Apr. 2012 and Dec. 2015 were enrolled. The median age of the patients was 60 years (30-77 years). The median overall survival (OS) of total patients was 13.3 months. The number of treatment cycles administered was 10 (2-20) and cRDI was 69.2% (35.6-91.2%). Fourteen of 51 patients (27.5%) underwent surgery and R0 resection was achieved in 11 patients (78.6%). Three patients received preoperative radiotherapy. The median OS of resected patients did not reach the 50% mark during the follow-up period compared with 13.3 months of OS in the patients without resection. Eleven of 14 resected patients did not experience recurrence during the follow-up of 10.7 months (1.8-23.5 months). The cRDI was higher in resected patients versus others (71.5 vs. 66.7%). The median time to resection was 6.7 months (3.2-14.3 months). Conclusions: FOLFIRINOX is considerable active regimen in patients with LAPC promising R0 resection rate. Future research should assess adequate duration and dose intensity of FOLFIRINOX and proper point of radiotherapy in the patients with LAPC to achieve higher rate of R0 resection.