For people with metastatic pancreatic cancer, the chemotherapy combination known as FOLFIRINOX results in better overall survival than standard treatment with Gemzar® (gemcitabine), but also increases side effects. These results were 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 close to 37,000 die from the disease. The disease is often diagnosed at an advanced stage, and treatment of advanced disease remains challenging.
Gemzar 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.
To compare FOLFIRINOX with Gemzar, researchers in France conducted a Phase II-III clinical trial among 342 patients with metastatic pancreatic cancer. Study participants had not previously been treated with chemotherapy. All had a good performance status, meaning that they were generally able to carry out activities of daily living.
- Overall survival among was 11.1 months among patients in the FOLFIRINOX group and 6.8 months among patients in the Gemzar group.
- Progression-free survival was also significantly improved among the FOLFIRINOX group: 6.4 months versus 3.3 months.
- Severe side effects that were more common in the FOLFIRINOX group included low white blood cell counts (sometimes accompanied by fever), low platelet counts, diarrhea, and sensory neuropathy (a nerve problem that causes pain, numbness, tingling, swelling, or muscle weakness).
The researchers conclude that compared with Gemzar, FOLFIRINOX improves survival but also increases side effects. They note “FOLFIRINOX is an option for the treatment of patients with metastatic pancreatic cancer and good performance status.”
Reference: Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. New England Journal of Medicine. 2001;364:1817-25.
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