Full dose neoadjuvant FOLFIRINOX is associated with prolonged survival in patients with locally advanced pancreatic adenocarcinoma

Final analysis of a phase II study of modified FOLFIRINOX in locally advanced and metastatic pancreatic cancer.

“…Published experience with this regimen in the locally advanced setting, however, has been confined to retrospective reviews (Hosein et al, 2012;Faris et al, 2013;Khushman et al, 2015). Although the retrospective data are promising, prospective studies with FOLFIRINOX in LAPC have not yet been reported.…”

Modified Appleby Procedure for Pancreatic Adenocarcinoma: Does Improved Neoadjuvant Therapy Warrant Such an Aggressive Approach?

“…17,18 These data have resulted in an increased interest in evaluating these multidrug regimens for patients with LAPC. 19,20 Specifically, Ferrone et al 21 reported that neoadjuvant administration of FOLFIRINOX for LAPC was associated with good radiological response, and that high rates of R0 resection could be achieved in these patients. Whereas in the past the oncologic benefits of these aggressive resections were believed not to outweigh the surgical risks, now, with more effective systemic therapies and improved downstaging based on radiologic imaging, performing aggressive surgical resections such as DP-CAR may be warranted.…”

Cattell-Braasch maneuver combined with local hypothermia during superior mesenteric artery resection in pancreatectomy

“…The short- and long-term outcomes of pancreatectomies associated with arterial resections have not been encouraging [3]. On the other hand, new more efficient treatments associated with better outcome are now available for patients with pancreatic cancer [5]. However, no data is available regarding the long-term outcome of extended resections in the context of these new and more efficient neo-adjuvant regimens.…”

“…Histology showed IPMN cancer. At the end of July, the patient started neo-adjuvant treatment with FOLFIRINOX [5] that was completed 4 months later without significant toxicity. A new CT scan, demonstrated at the multidisciplinary conference, showed no occurrence of distant metastases and a partial response with a reduced tumor size, however with remaining encasement of the SMA (Fig.…”

“…The recent development of new neo-adjuvant treatment regimens associated with a higher success rate of down-staging [5] has increased the interest of pancreatic surgeons on the role of extended surgery for patients affected by locally advanced pancreatic cancer. For this reason, the consensus paper from the International Study Group for Pancreas Surgery encourages further investigations of the role of more extensive surgery after neo-adjuvant treatment.…”