Ciência e terapia do câncer

Treatment of Pancreatic Adenocarcinoma with FOLFIRINOX-A Study of Efficacy and Safety in a Saudi Population

Abstract

Khaled Taher, Abdullah Al-Humiqani, Asma Ali, Abdullah Alsharm and Adnan Hussain

Background: FOLFIRINOX is emerging as the standard of care for fit patients with metastatic pancreatic cancer (MPC). However, use FOLFIRINOX associated with high toxicity rates reported in earlier studies; some physicians are reluctant to use it. We reviewed our experience with FOLFIRINOX in pancreatic adenocarcinoma, focusing on dose adjustments, toxicity, and efficacy. This study aims to evaluate FOLFIRINOX in the treatment of locally advance or metastatic pancreatic adenocarcinoma adult patients at King Fahd Medical City, Riyadh from January 2012 to December 2017.

Methods: We were review data for all locally advanced, or metastatic pancreatic adenocarcinoma adult patients with LAPC or MPC treated with FOLFIRINOX in King Fahd Medical City between January 2012 to December 2017. Efficacy, toxicity, and tolerability were evaluated

Results: Twenty-five patient with locally advance pancreatic cancer and twenty-four patients with metastatic pancreatic cancer were treated with FOLFIRINOX. The overall median survival time 9.27 month, the overall median progression-free survival was 7.44 month. Patient with LAPC had median PFS and OS of 9.7 and 12.7 months, respectively, and patient with MPC median PFS 5.3 month and OS 6.7 months. Forty-seven patients (96%) received FOLFIRINOX in the first line with median PFS 7.4 month and OS 9.27 month. In the whole cohort (LAPC and MPC), ten patients (20%) had partial response to chemotherapy. Further, 18 patients (36%) have stable disease. Twenty-One patients (42%) had no response as they progressed on FOLFORIRNOX. The most frequent grade ¾ toxicity was neutropenia (42%) renal toxicity (4%) and liver toxicity (6%), required emergency admission (51%) of patients.

Conclusion: The efficacy of FOLFIRINOX for pancreatic cancer was less than reported in the clinical trial while toxicity was similar to that report, selected patient and careful monitored toxicity can help the patient.