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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Effect of chemoradiotherapy vs chemotherapy on survival in patients with locally advanced pancreatic cancer controlled after 4 months of gemcitabine with or without erlotinib the LAP07 randomized clinical trial
Pascal Hammel,Florence Huguet,Jean-Luc Van Laethem,David Goldstein,Bengt Glimelius,Pascal Artru,Ivan Borbath,Olivier Bouché,Jenny Shannon,Jenny Shannon,Thierry André,Laurent Mineur,Benoist Chibaudel,Franck Bonnetain,Christophe Louvet +14 more
TL;DR: In this open-label, randomized trial involving patients with locally advanced pancreatic cancer with disease controlled after 4 months of induction chemotherapy, there was no significant difference in overall survival with chemoradiotherapy compared with chemotherapy alone and there wasno significant difference with gem citabine compared with gemcitabine plus erlotinib used as maintenance therapy.
Journal ArticleDOI
FOLFIRINOX for locally advanced pancreatic cancer: a systematic review and patient-level meta-analysis
Mustafa Suker,Berend R. Beumer,Eran Sadot,Lysiane Marthey,Jason E. Faris,Eric A. Mellon,Bassel F. El-Rayes,Andrea Wang-Gillam,Jill Lacy,Peter J. Hosein,Sing Yu Moorcraft,Thierry Conroy,Florian Hohla,Peter J. Allen,Julien Taieb,Theodore S. Hong,Ravi Shridhar,Ian Chau,Casper H.J. van Eijck,Bas Groot Koerkamp +19 more
TL;DR: Patients with locally advanced pancreatic cancer treated with FOLFIRINOX had a median overall survival of 24·2 months-longer than that reported with gemcitabine (6-13 months).
Journal ArticleDOI
Radiological and surgical implications of neoadjuvant treatment with FOLFIRINOX for locally advanced and borderline resectable pancreatic cancer.
Cristina R. Ferrone,Giovanni Marchegiani,Theodore S. Hong,David P. Ryan,Vikram Deshpande,Erin McDonnell,Francesco Sabbatino,Daniela Dias Santos,Jill N. Allen,Lawrence S. Blaszkowsky,Jeffrey W. Clark,Jason E. Faris,Lipika Goyal,Eunice L. Kwak,Janet E. Murphy,David T. Ting,Jennifer Y. Wo,Andrew X. Zhu,Andrew L. Warshaw,Keith D. Lillemoe,Carlos Fernandez-del Castillo +20 more
TL;DR: After neoadjuvant FOLFIRINOX imaging no longer predicts unresectability, traditional pathologic predictors of survival are improved, and morbidity is decreased in comparison to patients with clearly resectable cancers at the time of presentation.
Journal ArticleDOI
Targeting tumour-associated macrophages with CCR2 inhibition in combination with FOLFIRINOX in patients with borderline resectable and locally advanced pancreatic cancer: a single-centre, open-label, dose-finding, non-randomised, phase 1b trial
Timothy M. Nywening,Andrea Wang-Gillam,Dominic E. Sanford,Brian A. Belt,Roheena Z. Panni,Brian Cusworth,Adetunji T. Toriola,Rebecca Nieman,Lori A. Worley,Motoyo Yano,Kathryn J. Fowler,A. Craig Lockhart,Rama Suresh,Benjamin R. Tan,Kian-Huat Lim,Ryan C. Fields,Steven M. Strasberg,William G. Hawkins,David G. DeNardo,S. Peter Goedegebuure,David C. Linehan +20 more
TL;DR: This trial aimed to establish the safety, tolerability, and recommended phase 2 oral dose of the CCR2 inhibitor PF-04136309 in combination with FOLFIRINOX chemotherapy (oxaliplatin and irinotecan plus leucovorin and fluorouracil) and analysed the primary outcome by intention to treat.
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