Longer Overall Survival with FOLFIRINOX Versus Gemcitabine/nab-Paclitaxel in Pancreatic Cancer

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Prior to this study, there were no conclusive data directly comparing these regimens.
Prior to this study, there were no conclusive data directly comparing these regimens.
The following article features coverage from the ESMO World Congress on Gastrointestinal Cancer 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Median overall survival (OS) was longer with modified 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (mFOLFIRINOX) compared with gemcitabine plus nab-paclitaxel in patients with metastatic pancreatic cancer, though the safety profiles were similar, according to a retrospective study presented at the ESMO World Congress on Gastrointestinal Cancer 2018.1

Both mFOLFIRINOX and gemcitabine plus nab-paclitaxel are first-line options for the treatment of metastatic pancreatic cancer, but there are no conclusive data directly comparing these regimens. The goal of this study was to evaluate the safety and efficacy profiles of these regimens in patients with metastatic pancreatic cancer.

The retrospective study included 46 patients from two institutions. The median age at diagnosis was 63 and baseline characteristic were similar, except that the ECOG performance status was great than 1 in 48% of patients who received gemcitabine plus nab-paclitaxel compared with 4% of patients who received mFOLFIRINOX (P = .01).

The safety profile of mFOLFIRINOX and gemcitabine plus nab-paclitaxel was similar, including similar rates of grade 4 neutropenia, peripheral neuropathy, and diarrhea.

Though there was no difference in median progression-free survival between the groups, median OS was longer with mFOLFIRINOX at 14 months compared with 7 months with gemcitabine plus nab-paclitaxel (P = .02).

The authors concluded that these results suggest that mFOLFIRINOX is associated with prolonged OS compared with gemcitabine plus nab-paclitaxel with a similar safety profile. They noted, however, that “these results raise the issue of appropriately selecting patients with poor ECOG PS who can benefit from gemcitabine plus nab-paclitaxel for an adequate control of disease.”

Read more of Cancer Therapy Advisor's coverage of the ESMO World Congress on Gastrointestinal Cancer 2018 meeting by visiting the conference page.

Reference

  1. Pacheco-Barcia V, France T, Zogopoulos G, et al. Gemcitabine plus nab-paclitaxel versus modified FOLFIRINOX as first line chemotherapy in metastatic pancreatic cancer: A comparison of toxicity and survival. Ann Oncol. 2018;29(suppl 5;abstr P-164):v46. doi: 10.1093/annonc/mdy151.163

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