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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Locally advanced pancreatic cancer: a reliable contraindication to resection in the modern era?
Marc W. Fromer,Khaleel D. Wilson,Prejesh Philips,Michael E. Egger,Charles R. Scoggins,Kelly M. McMasters,Robert C.G. Martin +6 more
TL;DR: Despite a radiologic designation of locally advanced pancreatic cancer, certain subtypes of LAPC warrant surgical exploration provided the operative surgeon is prepared for major arterial and/or venous resection, similar to patients who are radiologically borderline resectable.
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Role of Neoadjuvant Therapy in Management of Pancreatic Cancer
Jia Li,Muhammad Wasif Saif +1 more
TL;DR: This meeting highlight focuses on recent updates on neoadjuvant therapy for both borderline resectable disease and potentially reseCTable disease, Abstracts #4120, #e15189, # e15226 and #TPS4158 will be discussed.
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Daily dose to organs at risk predicts acute toxicity in pancreatic stereotactic radiotherapy
Mauro Loi,Alba Magallon-Baro,Mustafa Suker,Casper H.J. van Eijck,Mischa S. Hoogeman,Joost J. Nuyttens +5 more
TL;DR: Daily dose to organs at risk predicts acute toxicity in pancreatic stereotactic radiotherapy Mauro Loi, Alba Magallon-Baro, Mustafa Suker, Casper Van Eijck, Mischa Hoogeman & Joost J. Nuyttens
Journal ArticleDOI
Locally advanced versus metastatic pancreatic cancer: two different diseases with two different treatment approaches?
TL;DR: The results of the SCALOP trial were reviewed and interpreted at the light of previous trials and of the more recent LAP-07 trial, which showed that radiotherapy in combination with chemotherapy does not add any valuable effect to chemotherapy alone.
Journal ArticleDOI
Implementation of a standardized approach to borderline resectable pancreatic cancer in a multisite community oncology program
Jonathan Bleeker,Christopher J. Sumey,Steven F. Powell,Preston D. Steen,Michael D. Keppen,Michele Lohr,Thavam Thambi-Pillai,Peter Kurniali,Miroslaw Mazurczak,Mark M. Gitau,Miran J. Blanchard,Ryan K. Nowak,Steven McGraw,Robert P. Sticca,Daniel Tuvin,Gary Timmerman +15 more
TL;DR: The feasibility of implementing a standardized approach to borderline resectable pancreatic cancer across multiple sites over a wide geographic area is demonstrated and adherence to protocol therapies was good and surgical outcomes are similar to many reported series.
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