by Dr. C.H. Weaver M.D. updated 4/2019
It appears that the chemotherapy combination known as FOLFIRINOX may improve survival in metastatic pancreatic cancer over a current standard-of-care, Gemzar® (gemcitabine). The results of this Phase III study were presented at the annual meeting of the American Society of Clinical Oncology and published in the New England Journal of Medicine.
Pancreatic cancer is one of the deadliest forms of cancer. Each year, approximately 43,000 people are diagnosed with pancreatic cancer in the United States and more than 37,000 die from the disease. The disease is often diagnosed at an advanced stage, and improved approaches to early detection and treatment are important research priorities.
Gemzar®, used alone or in combination with other drugs, has been a standard chemotherapy drug for the treatment of advanced pancreatic cancer for some time. Recent results, however, suggest that the combination known as FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) may be more effective.
A recent Phase III trial compared overall survival (OS) among patients treated with FOLFIRINOX with that of patients treated with Gemzar alone. The study involved 342 patients with metastatic pancreatic cancer.
- OS among patients receiving FOLFIRINOX was just over 10 months compared with approximately seven months among those receiving Gemzar alone.
- Progression-free survival was also significantly improved among the FOLFIRINOX group: six months versus three months.
- Side effects of therapy with FOLFIRINOX were greater than those observed with Gemzar alone but were considered manageable.
The researchers suggest that FOLFIRINOX should become the new standard-of-care for patients with metastatic pancreatic cancer. The increased incidence of side effects may, however, be a concern for some patients and physicians.
Reference: Conroy T, Desseigne F, Ychou M, et al. Randomized phase III trial comparing FOLFIRINOX (F: 5FU/leucovorin [LV], irinotecan [I], and oxaliplatin [O]) versus gemcitabine (G) as first-line treatment for metastatic pancreatic adenocarcinoma (MPA): Preplanned interim analysis results of the PRODIGE 4/ACCORD 11 trial. Presented at the 2010 annual meeting of the American Society of Clinical Oncology. June 4-8, 2010. Chicago, IL. Abstract 4010.
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