Modified-FOLFIRINOX in metastatic pancreatic cancer: A prospective study in Chinese population

Abstract

FOLFIRINOX chemotherapy has shown remarkable responses in patients with metastatic pancreatic cancer (MPC), and has significantly improved prognosis. However, FOLFIRINOX is currently not frequently applied in China because of its high incidence of adverse events, and there is no recognized optimization for this therapy in Chinese population. Modification of FOLFIRINOX may be better for its acceptance in China. In this study, we evaluated the efficacy and safety of modified-FOLFIRINOX in patients with MPC. A total of 62 MPC patients were treated with modified-FOLFIRINOX (no Fluorouracil bolus, 85% Oxaliplatin and 75% Irinotecan) between April 2014 and April 2017 in our institute. 40 of them were evaluated, with a response rate of 32.5% (13/40). The frequent grade 3/4 adverse events are neutropenia (29%) and alanine aminotransferase elevation (14.5%). No treatment-related death was observed. The median overall survival and median progression-free survival are 10.3 months and 7.0 months, respectively. In conclusion, modified-FOLFIRINOX had significantly improved tolerance with similar efficacy to FOLFIRINOX. These findings may provide evidence for the use of FOLFIRINOX in Chinese patients with MPC.

Monitoring Tumor Burden in Response to FOLFIRINOX Chemotherapy Via Profiling Circulating Cell-Free DNA in Pancreatic Cancer

“…Nevertheless, there were no detected pathogenic variants in genes regulating DNA damage response like BRCA1, BRCA2, ATM, and PALB2. It is worthwhile for further investigation as a significant proportion of patients develop acquired drug tolerance (14).…”

“…All included patients received FOLFIRINOX therapy as firstline treatment except one undergoing initial surgery. This regimen was modified by reducing Oxaliplatin and Irinotecan to 85% and 75% of their full dose, respectively, and omitting the Fluorouracil intravenous bolus (14). Assessment of treatment response was performed every four cycles of chemotherapy via abdominal enhanced CT and enhanced MRI of the liver.…”

A UGT1A1 genotype‐guided dosing study of modified FOLFIRINOX in previously untreated patients with advanced gastrointestinal malignancies

“…5 Trials with modified FOLFIRINOX (mFOLFIRINOX) have been conducted in which 5-FU, irinotecan, and/or oxaliplatin have been dose-reduced to decrease toxicity. [8][9][10][11] A phase 2 trial showed improved safety and maintained efficacy of mFOLFIRINOX in metastatic pancreatic cancer compared with historical controls. 8…”

Modified-FOLFIRINOX combined with deep regional hyperthermia in pancreatic cancer: a retrospective study in Chinese patients

“…Pancreatic cancer remains the fourth leading cause of cancerrelated death over the world in 2015 [1], with a 5-year survival rate of 1-5% [2]. In 2015, there are approximately 90,100 new pancreatic cancer patients in China, with an estimated 79,400 deaths [3,4]. Of all cancers, pancreatic cancer is ranked 10th in incidence and mortality is ranked 7th [3].…”