FOLFIRINOX in Locally Advanced Pancreatic Cancer: The Massachusetts General Hospital Cancer Center Experience
Jason E. Faris,Lawrence S. Blaszkowsky,Shaunagh McDermott,Alexander R. Guimaraes,Jackie Szymonifka,Mai Anh Huynh,Cristina R. Ferrone,Jennifer A. Wargo,Jill N. Allen,Lauren E. Dias,Eunice L. Kwak,Keith D. Lillemoe,Sarah P. Thayer,Janet E. Murphy,Andrew X. Zhu,Dushyant V. Sahani,Jennifer Y. Wo,Jeffrey W. Clark,Carlos Fernandez-del Castillo,David P. Ryan,Theodore S. Hong +20 more
TLDR
The use of FOLFIRINOX was associated with conversion to resectability in >20% of patients and the toxicities observed with the use of this regimen raise important questions about how to best treat patients with LAPC.Abstract:
The objective of our retrospective institutional experience is to report the overall response rate, R0 resection rate, progression-free survival, and safety/toxicity of neoadjuvant FOLFIRINOX (5-fluorouracil [5-FU], oxaliplatin, irinotecan, and leucovorin) and chemoradiation in patients with locally advanced pancreatic cancer (LAPC). Patients with LAPC treated with FOLFIRINOX were identified via the Massachusetts General Hospital Cancer Center pharmacy database. Demographic information, clinical characteristics, and safety/tolerability data were compiled. Formal radiographic review was performed to determine overall response rates (ORRs). Twenty-two patients with LAPC began treatment with FOLFIRINOX between July 2010 and February 2012. The ORR was 27.3%, and the median progression-free survival was 11.7 months. Five of 22 patients were able to undergo R0 resections following neoadjuvant FOLFIRINOX and chemoradiation. Three of the five patients have experienced distant recurrence within 5 months. Thirty-two percent of patients required at least one emergency department visit or hospitalization while being treated with FOLFIRINOX. FOLFIRINOX possesses substantial activity in patients with LAPC. The use of FOLFIRINOX was associated with conversion to resectability in >20% of patients. However, the recurrences following R0 resection in three of five patients and the toxicities observed with the use of this regimen raise important questions about how to best treat patients with LAPC.read more
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The efficacy and safety of the open approach irreversible electroporation in the treatment of pancreatic cancer: A systematic review.
Pabos Charalambous,Dimitrios Moris,Georgia-Sofia Karachaliou,Alexandros Papalampros,Nikolaos Dimitrokallis,Diamantis I. Tsilimigras,Dimitrios Oikonomou,Athanasios Petrou +7 more
TL;DR: Despite the paucity of literature and the low quality of evidence, the results regarding safety and efficacy appear to be encouraging, and the high morbidity seems to be mitigated by a demonstrated improvement in OS.
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Meta-analysis of FOLFIRINOX regimen as the first-line chemotherapy for locally advanced pancreatic cancer and borderline resectable pancreatic cancer
TL;DR: The meta-analysis shows that FOLFIRINOX, as the first-line therapy, has significant down-staging effects in patients with LAPC or BRPC, with a 40% R0 resection rate and the adverse events under control.
Journal ArticleDOI
Pancreatic Cancer: A Time to Change.
TL;DR: Although not the main subject of their paper, Katz and colleagues again demonstrated that pathologic response, preoperative Cancer Antigen (CA) 19-9, and lymph node ratio were the most important prognostic features.
Journal ArticleDOI
A case of metastatic pancreatic adenocarcinoma with prolonged survival after combination of neoadjuvant FOLFIRINOX therapy and synchronous distal pancreatectomy and hepatectomy.
Kyriakos Neofytou,Alexandros Giakoustidis,Elizabeth C Smyth,David Cunningham,Satvinder Mudan +4 more
TL;DR: The treatment of a patient with pancreatic ductal adenocarcinoma and a solitary liver metastasis who received nine cycles of FOLFIRINOX therapy with favourable response is detailed.
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Management of unresectable, locally advanced pancreatic adenocarcinoma
TL;DR: No significant increase in OS has been achieved with CRT when compared to chemotherapy (QT) alone in patients without disease progression after four months of treatment with QT, but a significantly better local control, that is, a significantly increase in the time to disease progression was associated with this approach.
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