ASCO: mFOLFIRINOX Improves Survival in Pancreatic Cancer
And, pre-op chemoradiotherapy linked to longer overall survival than immediate surgery
MONDAY, June 4, 2018 (HealthDay News) -- The oxaliplatin, leucovorin, irinotecan, and 5-fluorouracil (mFOLFIRINOX) regimen is associated with longer median disease-free and overall survival in pancreatic ductal adenocarcinoma; and, receiving chemotherapy before surgery is associated with better disease-free survival, according to two studies presented at the annual meeting of the American Society of Clinical Oncology, held from June 1 to 5 in Chicago.
Thierry Conroy, M.D., from the Institut de Cancérologie de Lorraine in Vanduvre-lès-Nancy, France, and colleagues randomized patients with histologically proven pancreatic ductal adenocarcinomas, 21 to 84 days after resection, to six cycles of gemcitabine (arm A; 246 patients) or 12 cycles of mFOLFIRINOX (arm B; 247 patients). The researchers found that the median disease-free survival was 12.8 and 21.6 months in arms A and B, respectively, with a median follow-up of 30.5 months (hazard ratio, 0.59). The median overall survival was 34.8 and 54.4 months in arms A and B, respectively (hazard ratio, 0.66).
Geertjan van Tienhoven, M.D., Ph.D., from the Academic Medical Center in Amsterdam, and colleagues randomized patients with (borderline) resectable pancreatic cancer to immediate surgery (arm A; 127 patients) and preoperative chemoradiotherapy (arm B; 119 patients). The researchers found that overall survival was significantly better with preoperative chemoradiotherapy (median, 13.5 versus 17.1 months; hazard ratio, 0.71; P = 0.047). Disease-free survival was also significantly better in arm B (median, 7.9 versus 11.2 months; hazard ratio, 0.67; P = 0.010).
"This is the first randomized clinical trial to show that preoperative treatment improves outcomes for people with early stages of pancreatic cancer who can have surgery," van Tienhoven said in a statement.