Role of FOLFIRINOX and chemoradiotherapy in locally advanced and borderline resectable pancreatic adenocarcinoma: update of the AGEO cohort.

Abstract

BACKGROUND:

FOLFIRINOX has shown promising results in locally advanced (LAPA) or borderline resectable (BRPA) pancreatic adenocarcinoma. We report here a cohort of patients treated with this regimen from the AGEO group.

METHODS:

This is a retrospective multicentre study. We included all consecutive patients with non-pre-treated LAPA or BRPA treated with FOLFIRINOX.

RESULTS:

We included 330 patients (57.9% male, 65.4% <65 years, 96.4% PS <2). Disease was classified as BRPA in 31.1% or LAPA in 68.9%. Objective response rate with FOLFIRINOX was 29.5% and stable disease 51%. Subsequent CRT was performed in 46.4% of patients and 23.9% had curative intent surgery. Resection rates were 42.1% for BRPA and 15.5% for LAPA. Main G3/4 toxicities were fatigue (15%), neutropenia (12%) and neuropathy (G2/3 35%). After a median follow-up of 26.7 months, median OS (mOS) and PFS were 21.4 and 12.4 months, respectively. For patients treated by FOLFIRINOX alone, or FOLFIRINOX followed by CRT, or FOLFIRINOX + /- CRT + surgery, mOS was 16.8 months, 21.8 months and not reached, respectively (p < 0.0001).

CONCLUSIONS:

FOLFIRINOX for LAPA and BRPA seems to be effective with a manageable toxicity profile. These promising results in "real-life" patients now have to be confirmed in a Phase 3 randomised trial.

• Authors: Edouard Auclin, Lysiane Marthey, Raef Abdallah, Léo Mas, Eric Francois, Angélique Saint, Antonio Sa Cunha, Angélique Vienot, Thierry Lecomte, Vincent Hautefeuille, Christelle de La Fouchardière, Matthieu Sarabi, Feryel Ksontini, Julien Forestier, Romain Coriat, Emmanuelle Fabiano, Florence Leroy, Nicolas Williet, Jean-Baptiste Bachet, David Tougeron, Julien Taieb
• Journal: British journal of cancer (Br J Cancer) Vol. 124 Issue 12 Pg. 1941-1948 (06 2021) ISSN: 1532-1827 [Electronic] England
• PMID: 33772154 (Publication Type: Journal Article, Multicenter Study, Observational Study)

Chemical References

• folfirinox
• Oxaliplatin
• Irinotecan
• Leucovorin
• Fluorouracil

Topics

• Adenocarcinoma (mortality, pathology, surgery, therapy)
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Chemoradiotherapy (methods)
• Cohort Studies
• Combined Modality Therapy
• Disease Progression
• Female
• Fluorouracil (therapeutic use)
• France (epidemiology)
• Humans
• Irinotecan (therapeutic use)
• Leucovorin (therapeutic use)
• Male
• Middle Aged
• Oxaliplatin (therapeutic use)
• Pancreatic Neoplasms (mortality, pathology, surgery, therapy)
• Retrospective Studies
• Survival Analysis
• Treatment Outcome