Tu1955 FOLFIRINOX ± Chemo-Radiation in Locally Advanced Pancreatic Cancer and Isolated Liver Metastasis: A Single Center Experience

Abstract

Background/Aim: FOLFIRINOX as neoadjuvant therapy for locally advanced pancreatic cancer has shown encouraging R0 resection and response rates. We report our experience for the overall response rate, R0 resection rate, progression free survival of FOLFIRINOX and chemoradiation in patients with) borderline resectable, locally advanced pancreatic cancer (LAPC) and LAPC with isolated liver metastasis.Methods: Retrospectively, 15 consecutive patients were given neoadjuvant FOLFIRINOX between 11/2011 and 8/2014. Radiographic review was used to allocate the patients into 3 groups (5 patients in each) based on National Comprehensive Cancer Network Criteria. Endpoints were objective response rates as per Response Evaluation Criteria in Solid Tumors Criteria, R0 resection rate and progression free survival. Results: All patients' characteristics are summarized in Table1. Out of 15, 5 were borderline resectable (Grp 1), 5 were locally advanced (Grp 2), and 5 had locally advanced disease with isolated liver metastases (Grp 3). Following neoadjuvant FOLFIRINOX the overall R0 resection rate was 27% (20% in Grp 1 and 2, 40% in Grp 3). The ORR was 26.7%. Median follow-up was 14 months. The progression free survival (PFS) and overall survival (OS) in surgical and non-surgical patient's seen in graphs 1 and 2. Conclusion: FOLFIRINOX possesses activity in patients with borderline-resectable and LAPC. The use of FOLFIRINOX was associated with conversion to R0 resectability in 40% of our patients, 27% after FOLFIRINOX alone and 13% after additional treatment with radiation. Despite having locally advanced disease with isolated liver metastasis, 40% of patients were able to proceed to R0 resection. There was also a survival benefit in patients getting neoadjuvant therapy with FOLFIRINOX and then resection. Prospective studies are advised to evaluate the true benefit of this treatment and survival rate.