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- Title
Role of FOLFIRINOX and chemoradiotherapy in locally advanced and borderline resectable pancreatic adenocarcinoma: update of the AGEO cohort.
- Authors
Auclin, Edouard; Marthey, Lysiane; Abdallah, Raef; Mas, Léo; Francois, Eric; Saint, Angélique; Cunha, Antonio Sa; Vienot, Angélique; Lecomte, Thierry; Hautefeuille, Vincent; de La Fouchardière, Christelle; Sarabi, Matthieu; Ksontini, Feryel; Forestier, Julien; Coriat, Romain; Fabiano, Emmanuelle; Leroy, Florence; Williet, Nicolas; Bachet, Jean-Baptiste; Tougeron, David
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>This is a retrospective multicentre study. We included all consecutive patients with non-pre-treated LAPA or BRPA treated with FOLFIRINOX.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.
- Subjects
FRANCE; THERAPEUTIC use of antineoplastic agents; PANCREATIC tumors; ADENOCARCINOMA; DISEASE progression; FOLINIC acid; RESEARCH; RESEARCH methodology; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; FLUOROURACIL; TREATMENT effectiveness; COMPARATIVE studies; SURVIVAL analysis (Biometry); COMBINED modality therapy; LONGITUDINAL method
- Publication
British Journal of Cancer, 2021, Vol 124, Issue 12, p1941
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-021-01341-w