Defining eligibility of FOLFIRINOX for first-line metastatic pancreatic adenocarcinoma (MPC) in the province of British Columbia: A population-based retrospective study.

Abstract

e14588 Background: FOLFIRINOX is a first line treatment option for patients with MPC and is associated with improved survival yet significantly more treatment-related toxicities than standard gemcitabine.. Our aim was to determine the proportion of patients with MPC who would be eligible for FOLFIRINOX therapy based upon the pivotal ACCORD study eligibility criteria. Methods: Patients with confirmed metastatic pancreatic cancer at the time of referral to the BC Cancer Agency between 2004-2007 were identified from the GI Outcomes Unit Database. Proportion of patients that met the ACCORD study eligibility criteria was determined by chart review. Criteria for FOLFIRINOX exclusion were assessed using descriptive statistics. Results: 100 consecutive patients with complete chart records and metastatic pancreatic cancer were identified. 52(52%) were male and the median age was 68. The most common sites of metastases were liver (63%) and peritoneum (22%). Only 26 patients fulfilled the ACCORD study eligibility criteria. The most common reasons for FOLIFIRINOX exclusion per ACCORD were poor ECOG score of 2 or greater (64%), age of 76y or greater (22%), elevated bilirubin (22%) and inadequate renal function (6%). Conclusions: Despite the proven survival benefit of FOLFIRINOX, only one-quarter of real-world patients with MPC would potentially be considered eligible for such combination chemotherapy.