Article ; Online: Safety and Efficacy of Modified FOLFIRINOX for Advanced Pancreatic Adenocarcinoma: A UK Single-Centre Experience.
2015 Volume 89, Issue 5, Page(s) 281–287
Abstract: Objectives: The combination of 5-fluorouracil (5-FU), irinotecan and oxaliplatin (FOLFIRINOX) is considered the first-line chemotherapy for fit patients with advanced pancreatic ductal adenocarcinoma (PDAC) but carries an unfavourable adverse event (AE) ...
| Abstract | Objectives: The combination of 5-fluorouracil (5-FU), irinotecan and oxaliplatin (FOLFIRINOX) is considered the first-line chemotherapy for fit patients with advanced pancreatic ductal adenocarcinoma (PDAC) but carries an unfavourable adverse event (AE) profile. We retrospectively evaluated the tolerability and efficacy of a modified FOLFIRINOX (mFOLFIRINOX) regimen: intravenous oxaliplatin 85 mg/m2, irinotecan 135 mg/m2, folinic acid 400 mg/m2 and 5-FU infusion 2,400 mg/m2 over 46 h, with routine subcutaneous filgrastim on a 14-day cycle. Methods: Records of 18 patients with advanced PDAC who received treatment with mFOLFIRINOX were reviewed. Imaging of measurable disease was assessed for response, and survival was measured from the date of commencing chemotherapy to disease progression and/or death. Results: Grade 3 or 4 AEs (n; %) included vomiting (5; 28), nausea (4; 22), diarrhoea (3; 17) and non-neutropaenic fever (3; 17). For patients with stage IV disease, 12/15 (80%) achieved at least stable disease as the best radiological response, with 7/15 (47%) objective responses. In this subgroup, median overall and progression-free survival were 9.3 months (95% CI 8.3-10.4) and 7.2 months (95% CI 4.7-9.6), respectively. Conclusion: Compared to full-dose FOLFIRINOX, our modified regimen resulted in lower haematological but only marginally improved non-haematological toxicity rates, with comparable efficacy outcomes. Prospective studies are required to validate these findings. |
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| MeSH term(s) | Adenocarcinoma/drug therapy ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Camptothecin/administration & dosage ; Camptothecin/adverse effects ; Camptothecin/analogs & derivatives ; Disease-Free Survival ; Drug Administration Schedule ; Female ; Fluorouracil/administration & dosage ; Fluorouracil/adverse effects ; Humans ; Irinotecan ; Leucovorin/administration & dosage ; Leucovorin/adverse effects ; Male ; Middle Aged ; Organoplatinum Compounds/administration & dosage ; Organoplatinum Compounds/adverse effects ; Oxaliplatin ; Pancreatic Neoplasms/drug therapy ; Retrospective Studies ; Pancreatic Neoplasms |
| Chemical Substances | Organoplatinum Compounds ; Oxaliplatin (04ZR38536J) ; Irinotecan (7673326042) ; Leucovorin (Q573I9DVLP) ; Fluorouracil (U3P01618RT) ; Camptothecin (XT3Z54Z28A) |
| Language | English |
| Publishing date | 2015-09-16 |
| Publishing country | Switzerland |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 250101-6 |
| ISSN | 1423-0232 ; 0030-2414 |
| ISSN (online) | 1423-0232 |
| ISSN | 0030-2414 |
| DOI | 10.1159/000439171 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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