FOLFIRINOX for Locally Advanced or Metastatic Pancreatic Ductal Adenocarcinoma: The Royal Marsden Experience

A patient-level meta-analysis of FOLFIRINOX for locally advanced pancreatic cancer.

“…After screening of the abstracts, 30 studies were selected for full text assessment, of which 13 studies fulfilled the inclusion criteria. (12,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) The excluded studies are presented in the webappendix, pages 2 and 3. Figure 1 presents the flowchart.…”

“…(12,(20)(21)(22)(24)(25)(26)(27) Of those 368 patients, 269 (73·1%) received G-CSF. Four studies gave G-CSF as primary prophylaxis.…”

“…The other seven studies determined LAPC based on multidisciplinary review board or retrospective evaluation of pretreatment imaging. (12,(19)(20)(21)(25)(26)(27) Only three studies presented a patient cohort including only LAPC patients. (22,26,30) None of the studies described a staging laparoscopy as part of the diagnostic work-up.…”

“…(19)(20)(21)(22)(23)(24)(25)(27)(28)(29)(30) Three studies used the NCCN criteria (22,29,30), and three studies used the AHPBA/SSO/SSAT criteria (23,24,28) to define LAPC. The other seven studies determined LAPC based on multidisciplinary review board or retrospective evaluation of pretreatment imaging.…”

“…(23) One study included 5 patients who received FOLFIRINOX not as first-line treatment and these patients were excluded from the survival analysis. (27) All studies defined survival as the time from the start of FOLFIRINOX. The median OS ranged from 10·0 to 32·7 months across studies with a patient-level median OS of 24·2 months [95% CI 21·6 -26·8 months].…”